Office of the Police and Crime Commissioner for Bedfordshire
Grant Funding (over £2,000) Application Form
Please complete all sections of the form
Part one – Organisation Details
1. Your organisation’s details:
This will be the organisation that payment is made to if your application is successful
Organisation name
Organisation postal address
Postcode
Email address
Website
2. How would you best describe your organisation?
Community Safety Partnership
Social Enterprise (e.g. Community Interest Company)
Local Authority
Voluntary or community organisation/group
Company limited by guarantee
Other (please describe):
Registered Charity Number (If applicable)
Do you have a written constitution (governing document)? Yes/No
If not, please attach your governance structure document.
3. Who is the main contact person for this organisation/project?
Please make sure that this person knows all aspects of your project
Title
First Name
Surname
Position in organisation
Contact address
Postcode
Email address
Contact telephone number
4. Please supply a secondary contact person for your organisation:
Title
First Name
Surname
Position in organisation
Contact address
Postcode
Email address
Contact telephone number
5. If your service or activity is a branch of a larger organisation please provide its name.
6. What are the stated purposes (objectives) of your organisation?
This should be based on your governance documents e.g. constitution.
(maximum 100 words)
Part Two – About your project / service / activity
7. What is the name of your project / service / activity to which this application relates?
8. Please provide a brief summary of your project.
(maximum 75 words)
9. Please describe the project you want us to fund.
Tell us about:
· Who is your project aimed at?
· What is the problem or issue you want to address with your project?
· What you will do?
· What services or activities you will carry out?
· And what this will achieve?
(maximum 750 words)
10. How have you identified a need for the project and how have you ensured it does not duplicate any existing provision available in Bedfordshire?
(maximum 350 words)
11. Please give a minimum of three intended outcomes that your project / service / activity will achieve and how these will be measured. The outcomes you choose must show the changes your project will make and must link to the PCC priorities.
(examples can be found in the application guidance)
Outcome 1: (maximum 30 words)
Measure 1: (maximum 100 words)
Outcome 2: (maximum 30 words)
Measure 2: (maximum 100 words)
Outcome 3: (maximum 30 words)
Measure 3: (maximum 100 words)
Outcome 4: (maximum 30 words)
Measure 4: (maximum 100 words)
Outcome 5: (maximum 30 words)
Measure 5: (maximum 100 words)
12. Please tell us how you will involve users / participants in the ongoing development of your project / service / activity. How will you seek participant feedback?
(maximum 250 words)
13. Is your project / service / activity:
New / Ongoing14. Please specify the start and end dates for this project / service / activity
StartEnd
15. Where will your project / service be delivered?
16. What is the anticipated total number of Bedfordshire residents who will benefit directly from your project?
17. Please tell us which geographical area(s) will benefit most from your project / activity / service to which this application relates?
(please tick all areas that apply)
Bedford Borough (tick this box for all of area)Bedford Rural
Bedford Urban
Central Bedfordshire (tick this box for all of area)
Ampthill and Flitwick
Cranfield, Marston and Woburn
Dunstable and Houghton Regis
Leighton Buzzard and Linslade
Sandy and Biggleswade
Shefford, Stotfold and Arlesey
Luton (tick this box for all of area)
Central Luton
East Luton
Luton Airport
Luton Town Centre
North Luton
South Luton
West Luton
All of Bedfordshire
18a. Which of the following priority areas will your project/service/activity contribute towards?
Violence Against Women And GirlsYouth at risk
Innovative Projects
Capacity building
18b. Tell us how your project will contribute to each of the priority areas you have ticked.
(maximum 400 words)
19. How will you involve other organisations in your project?
For example, making or receiving referrals, working together to deliver aspects of the project, co-operating in other ways.
Part Three - Project Costs
20. Please provide full details of the costs of the project you are asking us to fund. If any of the costs do not fit into these headings, please detail them in ‘other costs’. Tell us in the ‘description of costs’ column what each item is and how much it is costing.
Please give a full breakdown under each section – e.g. how many hours at how much per hour
Type of cost / Description of costincluding full breakdown / Total cost £
(incl. Non recoverable VAT)
Staffing
Project
Equipment
Management
Other costs
Total cost of your project / £
Amount requested from Police and Crime Commissioner’s Grant Fund / £
If the total of your project budget is higher than the amount requested, how much has been raised so far? / £
21. How will you fund any gap between the cost of the project and the award you are seeking from us?
If you have secured funding from other organisations/funding bodies please provide us with the name of the funder and the amount they have awarded.
If you are applying to any other trust(s) or organisation(s), please give details, including a date when you expect to hear from them.
Please give details of any contribution in kind or from your own funds towards your project.
22. Have you applied to the Office of the Police and Crime Commissioner or Bedfordshire Constabulary for a grant for this project or any other grant within the last two years?
Yes / NoDetails / Amount
23. Please outline how your organisation intends to sustain the project or bring the project to a close once the funding period ends.
24. Have you had any funding relevant to your project / service / activity withdrawn or reduced in the last two years? Please explain the circumstances behind this.
25a. If funding is available, do you wish for your project to be considered for funding over a three year period? To support our partners and to promote sustainability, we are considering funding some projects over a three year period. Three year funding will be dependent on the level of monies allocated to the Police and Crime Commissioner and the quality of bids provided and services delivered. Final funding cannot therefore be guaranteed.
YES/NO
25b. If you answered yes to 25a. please explain how you think your project will continue to develop and benefit victims in Bedfordshire?
Part Four – Financial Information
26. Income, Spending and Reserves
What are your levels of income and spending for the past three financial years?Income / Spending
Last full financial year / £ / £
Previous financial year / £ / £
Previous but one financial year / £ / £
Please state the amount of free reserves (unrestricted and undesignated funds) held by your organisation
Unrestricted - £Restricted - £
Part Five – Other Information
27. How did you hear about the Police and Crime Commissioner’s Grant Fund?
28. If applicable, please confirm whether you have the following documentation.
You will be required to provide the appropriate documentation should you be successful in your application and where it is relevant.
· Public Liability Insurance ☐ Amount:
· Employers Liability Insurance ☐ Amount:
· Indemnity Insurance ☐ Amount:
· Adult Safeguarding Policy ☐
· Safeguarding Children Policy ☐
· Equality and Diversity Policy ☐
· Vehicle Insurance ☐
· Health and Safety Policy ☐
· Business Plan ☐
29. Tell us about your staff structure
Number of trustees and/or members of the management committee?Number of paid staff?
Number of volunteers (excluding trustees)?
30. How will your staff ensure that your project will reach the widest audience and those with the most need?
(maximum 500 words)
31a. Does your project involve work with children, young people under the age of 18 or vulnerable adults?
YES/NO
If yes, as a minimum we expect you to be able to demonstrate that you:
a) have safeguarding policies in place that are appropriate to your organisation’s work and the project you are asking us to fund
b) review your safeguarding policies annually
c) complete a safer recruitment and selection process for staff and volunteers who work with children, young people or vulnerable adults, including checking criminal records, Disclosure and Barring Service (DBS), and taking up references
d) carry our DBS checks on appropriate staff/volunteers at least every three years
e) follow statutory or best practice guidance on appropriate ratios of staff or volunteers to children, young people or vulnerable adults
f) provide child protection and health and safety training or guidance for staff and volunteers
g) carry out risk assessments, when appropriate
h) secure extra insurance cover, when appropriate
31b. Does your organisation meet these requirements?
If no, please state which are not met.
YES/NO
Privacy Note:
The information you have supplied in this form will be used to process your grant application. In order to make a decision on your application some of the depersonalised information provided may go into a public decision report. In addition your application form may be shared with third parties and partner agencies who will be involved in the decision making process or whom can verify specific facts within your application.
In addition, we may be required to disclose information outside the Office of the Police and Crime Commissioner for Bedfordshire to help prevent fraud, or if required to by law.
We will not be able to process your application if you do not provide all the information requested.
Full grant applications will be retained for a maximum of 6 years (plus the current year).
Information will be retained on a database at the Office of the Police and Crime Commissioner for Bedfordshire for statistical and monitoring purposes.
Transparency/Open Data:
If your application is successful, details of the grant will be published on the Bedfordshire Office of the Police and Crime Commissioner website in accordance with government policy. (No personal information will be published).
Declaration:
I am authorised to apply for the grant set out in this application for named organisation.I certify that all the particulars given in the form are correct and that any grant monies received from the Office of the Police and Crime Commissioner will be used for purposes stated in this form. The Office of the Police and Crime Commissioner reserves the right to reclaim any grant monies not used for the purposes stated on this form.
I will inform the Office of the Police and Crime Commissioner if any of the particulars and information given ceases to be correct and will provide updated information as required.
I understand that the grant applied for is dependent on the level of monies allocated to the Bedfordshire Police and Crime Commissioner and Bedfordshire Police from the Ministry of Justice and Home Office. I therefore understand that funding cannot be guaranteed.
I agree to the Privacy Note above:
Signature:
Name:
Date:
Thank you for applying to the Bedfordshire Police and Crime Commissioner for funding for your project / service / activity for 2017 / 18.
To ensure that your application is recorded correctly please email the Commissioning Team at:
and provide the following information, as entered on your application:
· Name of Organisation
· Name of Project applied for
· Name of main contact person at the organisation (as per question 3)
· Date and time of final submission
Once we have received this information one of the Commissioning and Programme Management Team will log the application and send you an acknowledgement.
The Office of the Police and Crime Commissioner accepts no responsibility if we do not receive your application or if you have not completed the application process fully.
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O2K Application