Dumfries and Galloway Community Led Local Development Fund (CLLD)Grant Application Form 25-26

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Section 1 - Contact Details

Organisation Name

Address

Town

Postcode

Telephone

Website

General / Office Email

Are you part of a larger regional or national organisation?

YesNo

Main Contact Person
These are the details that will be used for correspondence purposes.

Title

Forename(s)

Surname

Job Title

Work / Office Phone

Mobile Phone

Secondary Contact Person
These are the details that will be used for correspondence purposes if the main contact is unavailable.

Title

Forename(s)

Surname

Job Title

Work / Office Phone

Mobile Phone

Section 2 - About the Organisation

When was your organisation established?

What type of organisation are you?

Scottish Charitable Incorporated Organisation (SCIO)SMEs (limited companies, partnerships or sole traders with asset lock)Public sector organisationsCo-operativesConstituted community groupsCommunity interest companiesCommunity benefit societyPlease check the relevant box(es) and input the charity and company numbers where appropriate. All Scottish charity numbers start with SC0 and not SCO. Please enter your number without spaces i.e. SC012345 not SCO 12345.

Charity Number

Company Number

Staffing and volunteers
How many of each of the following are involved in the organisation?

Full time staff

Part time staff

Trustees

Volunteers

(excluding management committee)

Briefly describe the purpose of your organisation, outlining the main activities and services you provide and to whom.

Section 3 - Financial Details

What was your total income over the last accounting year?

Please state the name, position and company of the independent examiner who has signed your accounts

Bank account name

i.e. name of or account holder or organisation; Do NOT provide the name of the Bank/Building Society.

Bank account number

Bank Sort Code

Do not enter spaces or dashes

If your account name does not match your organisation name, please explain why

Section 5 - Details of Grant Funding Requested

What is the total cost of the project?

How much money are you applying to us for?

Please confirm that these activities are not, and cannot be funded from elsewhere.

I confirm

Please provide a full breakdown of the grant request. Ensure the breakdown adds up to the amount you have requested and provide the calculations for each item in the table below.

This funding is subject to meeting the principles of the Fair Work Framework. Fair work is work that offers effective voice, opportunity, security, fulfilment and respect; that balances the rights and responsibilities of employers and workers and that can generate benefits for individuals, organisations and society.

Revenue Spending - do not enter £ symbols

Item/Description

Cost

Revenue?

Revenue

Capital Spending - do not enter £ symbols

Item/Description

Cost

Capital?

Capital

Total Revenue

Total Capital

Revenue %

Total

Does the total match the amount being applied for?

If you are applying for a capital grant, please tell us about your exit strategy.

If applying for a capital grant, can this project run if the revenue element is not funded?

YesNo

Please tell us about the match funding you have applied for or secured for this project

Funder	Amount secured / applied for?
	£
	£
	£

If you have not secured all your funding for this project, what are your plans?

Please indicate if you have any of the following supporting documentation

Design ProposalsBusiness PlanFeasibility ReportOther

Other, please state

Please indicate the planning status of your project (If applicable)

Project does not require planningIntending to submit planning applicationPlanning application submittedPlanning approved

Please include any further details that support the deliverability of your application (Capital Projects Only)

Section 6 - Supporting Documents

Please confirm you have the appropriate policies and procedures in place to deliver this project.

Please explain

Please confirm you have a safeguarding policy if your organisation’s core work or the project you are applying for involves children or vulnerable adults.

Please explain

Please confirm that you have an EDI (Equality, Diversity, and Inclusion) policy.

Please explain

This funding is subject to meeting the principles of the Fair Work Framework. Please confirm that your project will adopt the framework.

Please explain

If your grant request is for any item(s) costing more than £3,000 please confirm that you obtain at least two quotes for each of those items.

A copy of a recent bank statement with your bank name, account name, sort code and account number will be uploaded with your application.

A copy of your constitution (or other governing document) submitted with the application is the most up-to-date version adopted by the members of the organisation.

If you do not have the bank statement available electronically, please submit the application and email it as soon as possible to clld@tsdg.org.uk.

All your documents must be received within 5 days of submitting or by the application deadline, whichever is sooner.

Please note that your application may not be processed for assessment until all the required documents, listed above, have been received.

Section 7 - Declaration

I declare that the information contained in this application is correct, and that I am authorised to make the application on behalf of the named organisation and with whom it has been discussed. I understand that decisions made by the LAG are final.

Full Name

Date

By submitting your application, you agree to allow Third Sector Dumfries and Galloway to retain your personal data on its database to process your application. We will use the information you give us to help assess your application and administer any grant we award you. We may also publish this information on our website or use it to analyse our grant making for our own research or for others. We may give copies of this information to individuals and organisations we consult when assessing applications, when monitoring grants and evaluating our programmes. We may also use this information for training purposes. This is in line with our Privacy Notice which you can read at www.tsdg.org.uk

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