Cost of Living Emergency Fund Grant Application

Grant name
Cost of Living Emergency Fund Grant Application Form

Please download and read the grant guidance before completing your application

Grants of up to £10,000 are available to help Animal Rescues cover activities directly affected by the Cost of Living Crisis.

Applicants need to have been ADCH members on the 17th November 2022.

If we receive many more applications than we have funds to support, priority will (in the first instance) go to:

- Rescues whose turnover is below £1,000,000

- Rescues who have not yet received emergency funding from another organisation or fund.

Please note – we will only be able to offer one grant to a registered Charity as logged with the Charity Commission. Therefore if you are a branch of a large National Organisation, with whom you share the registered Charity Number, please check with your Head Office first and ask for their commendation, before submitting your application.

Applications for food should be made via the Mars Pet Care Fund - details available at https://adch.org.uk/marsfoodfund/

If you need any assistance, please email grants@adch.org.uk

1. Organisation Information
1.1 Name of Applicant Organisation (and legal name if different)*
1.2 Type of Organisation (Charity/ Not for profit)*
1.3 Charity registration number (if applicable)
1.4 Registered address including postcode *

Street Address

Street Address Line 2

CityCountry

Postcode
1.5 Website
1.6 Main telephone number*

Area CodePhone Number
1.7 CEO/ or equivalent*

First NameLast Name
1.11 My CEO / Chair is aware of the application and is happy for me to submit it*

YesNo
1.8 Primary contact name (person who will be responsible for the grant activity) *

First NameLast Name
1.9 Primary contact phone number*

Area CodePhone Number
1.10 Primary contact email address*
example@example.com

2. Bank Information

Please note this must be the organisation’s bank account. We will not pay into a personal bank account.
2.1 Name of Bank*
2.2 Bank Address*

Street Address

Street Address Line 2

CityCountry

Postcode
2.3 Account Number*
2.4 Sort code*
(XX-XX-XX)
2.5 Name of authorised signatory*

First NameLast Name

3. Current situation
3.1 Please tell us how many animals are currently in your care awaiting rehoming *
3.2 Have you stopped admitting further animals during the Crisis? If not please explain *
3.3 Please tell us how many animals you rehome a year *

4. Finance

Please complete the following re. your finances and attach the SOFA (Statement of Financial Activities) and Balance Sheet from your most recently audited accounts and current bank balance in the form of a bank statement or printout. Priority will be given to those rescues who DO NOT have more than 3 months expenditure in hand. Please complete in £Sterling.
4.1 Breakdown of projected MONTHLY running costs *
4.2 Breakdown of projected MONTHLY income *
4.3 Current cash available*
4.4 Other assets – such as stocks & shares, restricted legacy income etc *
4.5 Does your charity pay rent or have a mortgage or bank loan?*

YesNo
4.6 Please give brief details here for any rent, mortgage or bank loans
4.7 Number of full and part-time paid workers still working at this time *
4.8 Have any staff been made redundant or had their hours reduced?*

YesNo
4.9 How many staff have been made redundant or had their hours reduced? Please provide details
4.10 Have you applied for any other emergency grants?*

YesNo
4.11 Do you have more than 3 months expenditure in hand?*

YesNo
4.12 For reserves remaining in investments - can you demonstrate there would be a significant cost or loss of value associated with liquidating them?*

5. Supporting documents
5.1 Please upload your SOFA (Statement of Financial Activity), Balance Sheet and Current Bank Balance information *

Cancelof

6. Impact of the Cost of Living Crisits
6.1 Please give a very brief summary of how the Cost of Living crisis is affecting your charity*
6.2 What actions have you put in place to mitigate the problems caused by the crisis? Detail your strategy to get through the crisis to ensure the future of your charity *

7. Budget
7.1 How much are you applying for?*
(Please note that the maximum grant is £10,000 but depending on interest/ numbers of applicants, you may not receive the full amount)
7.2 Please tell us very briefly here how you would use the Emergency Grant. *

Please note

On receipt of an application you will receive an acknowledgement together with a reference number which you must use in subsequent correspondence.

Successful applicants will be required to agree to any specific conditions attached to a successful outcome before any payment can be released. Payments will be conditional on receipt of a satisfactory progress report, along with a case study – outlining what has been achieved through receiving the Grant and the benefits to dogs and/ or cats. All successful applicants will be required to complete a final evaluation of how the grant helped them in spring 2023.

Your privacy rights

The data you provide in your application will be used by the ADCH Grants Allocation Committee to assess your Grant Application and communicate with you regarding your application. Should your application be successful we will use your data to manage your grant. To help us better understand our applicants, and to tailor our communication with you, we may analyse the information you provide. We sometimes use information from public sources. We may also contact you to ask if you are willing to share your story, to help us help other cats and dogs. We won’t use your data for marketing or fundraising purposes. By applying for this Grant, you consent to the ADCH processing your data for this purpose. Further information about how we protect and use your personal data is set out in our Privacy Policy which you can find here
Agreement to supply impact report*

If my application is successful I confirm that I will provide a short impact report and case study showing how my rescue has benefitted from this Grant
Please confirm you have uploaded the relevant documents above (see 5.1), without these we will not be able to process your application*

SOFA (Statement of Financial Activity)Balance SheetCurrent Bank Balance information
Signature*

Clear
Date*

MonthDayYear
Date
Name (please print)*

First NameLast Name
Position*
Should be Empty:

1. Organisation Information

2. Bank Information

3. Current situation

4. Finance

5. Supporting documents

6. Impact of the Cost of Living Crisits

7. Budget