Application Form
Sheers Barton (Lawhitton) Wind Turbine Community Benefit Fund
Fund details
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Contact information
Name of organisation/group/individual:
*
Personal details:
*
Title
First Name
Last Name
Organisation address (if applicable):
Correspondence address (if different):
Position in organisation (if applicable):
Daytime telephone number:
*
Please enter a valid phone number.
Mobile telephone number
*
Please enter a valid phone number.
Email address:
*
(Please note all correspondence will be carried out via e-mail.)
About your organisation (if applicable)
Please describe the main activities of your organisation:
When did your organisation start?
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Day
-
Month
Year
Do you have a Health and Safety Policy and appropriate Insurance?
Yes
No
If you work with children and young people or safeguarding adults, do you have Disclosure & Barring Service Policy and Safeguarding Adult Policy respectively?
Yes
No
Do you have a Sustainability/Environmental Policy?
Yes
No
Please upload policies here:
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Have your staff and volunteers all passed DBS checks?
Yes
No
Is your organisation a Registered Charity?
Yes
No
If yes, what is your Charity Number?
Does your organisation have a constitution?
Yes
No
If yes, please attach a copy here:
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How many paid staff does your organisation employ?
How many of your staff identify as men?
How many of your staff identify as women?
How many of your staff identify as non-binary?
How many of your staff identify as trans?
How many of your staff are disabled?
How many of your staff are young people?
How many of your staff are black or people of colour?
Which geographical area(s) are you working in?
Please include postcode(s).
About your project and the need
Please write a brief description of the project you are seeking to fund:
(Please include the name of your project in your explanation.)
Please explain the need of your project you are seeking funding:
(Please include the name of your project in your explanation.)
If possible, please explain how you know the people in your community want this project/activity and what evidence have you collected to demonstrate this?
(Please include the name of your project in your explanation.)
If you have any documents to support this, please upload here:
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Project start date:
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Day
-
Month
Year
Project enddate:
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Day
-
Month
Year
How many volunteers are involved with your project?
How many paid staff are involved in your project?
Beneficiaries
Who will benefit from your project?
Please explain how the people or community accessing your services are disadvantaged, and tell us about the issues they face?
Approximately how many people will benefit?
Outcomes / monitoring
What do you aim to have achieved by the end of the project you are seeking to fund? Tell us how you will know if your project has been successful?
How do you see this project/activity progressing after this funding comes to an end?
Finance
(for completion by organisations only)
Date of latest annual or management accounts: (DD/MM/YYYY)
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Day
-
Month
Year
Total income on accounts:
Total expenditure on accounts:
Total amount of unrestricted reserves:
How many cheque signatories are required?
The Funding You Are Asking For
How much money are you applying for?
(for maximum grant awards please refer to the grant guidelines)
Is this money for new work, or to continue funding existing work?
New
Existing
Please provide a breakdown of TOTAL costs for your project, highlighting what you want the Community Fund money to be specifically spent towards and what you have already raised funds for (either fill in this box or upload a document below):
Please provide a breakdown of TOTAL costs for your project, highlighting what you want the Community Fund money to be specifically spent towards and what you have already raised funds for (either upload a document here or fill in the box above):
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Paying You
If your application is successful payment, will be made via cheque or BACS.
Checklist - This application will ONLY be considered if you enclose the following:
Applications from organisations:
A photocopy of your signed, up to date constitution/set of rules
A copy of your most recent accounts (if your organisation is more than a year old)
An up to date bank statement
Two competitive quotes for any expenditure over £1,000.00
Applications from individuals:
Proof of identification and address
Two competitive quotes for any expenditure over £1,000.00
Please upload any supporting documents:
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Data protection
This information will be stored electronically and will remain confidential to the Low Carbon Fund. It will not be used for any other purposes without your agreement.
Next steps
A copy of this completed form will automatically be emailed to the applicant. Please retain a copy for your own records. We may ask you to refer to your application form during the application process and you will need to refer to it when filling out an end of grant report at the end of your project.
Declaration
It is essential that you understand and agree to sign up to the following statements:
We agree to abide by the terms and conditions of the grant as they are set out in the application form and the accompanying guidance. If any factors change we will inform The Low Carbon Fund and understand that all or part of the grant may have to be repaid.
We certify that the information contained in this application is correct, and where applicable, we are authorised by the organisation to accept these conditions on their behalf.
If successful we will not use the grant for any other purposes, other than those specified, without first receiving authorisation from The Low Carbon Fund. We will not use the grant for goods or services already ordered or purchased without express authorisation from The Low Carbon Fund.
We understand that the grant may not include everything requested in the application.
We will not dispose of any capital items purchased with the grant without the permission of the funder.
We agree to participate in monitoring, auditing and evaluation relating to this fund as detailed in the guidance.
We will keep the receipts for any payments made with this grant and will send copies of the receipts along with a final project report to The Low Carbon Fund at the end of the project, or within a year, whichever is sooner.
We agree to publicise The Low Carbon Fund by including their logo in any promotional publicity we produce such as newsletter, press releases and website.
If the application is from an organisation and you leave the organisation or can no longer fulfill your responsibilities, or someone else takes over responsibility for the grant on behalf of the organisation, you must inform us immediately.
I/We understand and agree to sign up to the statements above:
*
Yes
No
Organisation chair/secretary
First Name
Last Name
Signature
Committee member
First Name
Last Name
Signature
Individual
First Name
Last Name
Signature
Date
-
Day
-
Month
Year
Date
One last question...
How did you hear about us?
Submit
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