Phyllis Grant Community Fund - Application FormAbout your organisation/groupName of your Organisation/GroupMain contactPosition in groupAddressPostal CodeEmail address of main contactMain telephone numberWebsiteThis section only to be filled in by Community GroupsBank account detailsBank NameBank AddressAccount NameAccount NumberSort CodeAbout your applicationWhat do you need the funding for?How will it bring people together?Describe your project activity and how you will deliver it What PSBL theme does your project best link into? E.g. Youth, digital, mental health etc.What is the start date for the project and when will it be completed?Is the timetable for the delivery for this realistic?Start dateEnd dateWhat will be the full impact of your project?The Local CommunityHow many people will be involved in organising it and what will they be doing?How many people will benefit from it?Project BudgetHow much are you applying for?£Breakdown by cost Activity:ItemCost £Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£Text InputNumeric Field£TOTALNumeric Field£How does your project represent good value for money? E.g. getting quotes, fundraising etc.How will you provide us with information to show how people have benefitted? Photos/video Data taken from sign up sheets/attendance lists Data/information taken from surveys/interviews Before and after case studies Other (please specify)Supporting Documents Checklist for Community GroupsPlease include the following documents with your applicationIf you are unable to send any of the documents, please explain in the corresponding field below.a. Constitution, Memorandum, Terms of reference or Set of Rules*Choose File Text Inputb. Names and addresses of the management committee and people managing the projectChoose File Text Inputc. Copy of the working agreement between resident/community group applying and their fund holderChoose File Text Inputd. Public Liability Insurance certificate. If applicableChoose File Text Inpute. Child Protection Policy and/or Vulnerable Adults Policy, if applicable*Choose File Text Inputf. Evidence of Disclosure and Barring Service (DBS) checks (previously CRB checks) (for projects working or volunteering with children or vulnerable adults)Choose File Text Inputg. Health and Safety policy*Choose File Text Inputh. Most recent annual accounts or 12 month cash flow projectionChoose File Text Inputi. Risk Assessment of project Choose File Text Inputj. Valid Food Hygiene Certificates, if applicableChoose File Text InputDeclaration and SignaturesI/We confirm that the information given is true and I/we have formally agreed to deliver these activities, if funded. I/We understand that unless I/we submit all the necessary documentation and attend the fund allocation event on 17th or 25th April, this project cannot be funded. Your NameSignatureDateFor Community GroupsName of ChairSignatureDateName of Treasurer/SecretarySignatureDateName of Project LeadSignatureDateSubmit Form
