APPLICATION TO:
CORPORATE SERVICES BUSINESS GROUP
SMALL GRANTS FUND 2014/2015 /

Return to:

Community Engagement Team, The Town Hall, Hornton Street,

Kensington, London W8 7NX

Direct Line: 020 7598 4633

E-mail:

Part 1

1.Name of Organisation:

Charitable Number (if applicable):

If not a registered charity: Give brief outline of structure and history of group:

Address:

Person to Contact:Tel No

Email:

Signature:

Position:

2.Criteria

Please tick the specific criteria for which you are applying for a small grant (please refer to the application information and criteria):

Criteria / Please tick
  1. Items of equipment (max grant £1,500)

  1. Community events, outings and festivals (max grant £1,500)

  1. Publicity material or meeting the costs of taking part in funding/information events which publicise the organisation’s services (max grant £1,500)

  1. Volunteer training and expenses (max grant £1,500)

  1. Small scale building work to improve access, efficiency, security or improve sustainability (max grant £1,500)

  1. Unexpected one-off costs that support organisation sustainability which the organisation cannot meet (max grant £7,000)

3.Total grant applied for:£

As relevant, supply full revenue budget and/or copy of quotes or costs for capital expenses. If the grant applied for does not cover the full costs of the project, please detail how the remaining funding required will be sourced and if this has been confirmed.

3a.If your application is against criteria 6 and is greater than £1,500 please provide a detailed statement below on how the grant will support the sustainability of the organisation.

4.State briefly the purpose of the grant requested.

5.Give details of who would benefit if the grant was provided (i.e. individuals or groups the service is aimed at, estimates of number of people who would be expected to benefit, percentage of those benefiting who are residents of Kensington and Chelsea) and explain why the grant is needed.

6.Please state how the grant will deliver the aims of the Corporate Services Funding priorities 2013-14.

7a.Have you received any funding from RBK&C Council in the last 12 months? Yes or No.

If yes, give details including type of grant and Council Business Group.

7b.If the organisation has not received a grant from Corporate Services within the last two years, give the name of an independent referee who knows about the organisation.

Name:

Organisation:

Position:

Address:

Telephone Number:Email:

Has the referee been told that they will be approached?Yes/No

7.Have you made other applications to this Council or other funders?

If yes, give details.

8.Management Committee

Name of Chair:

Name of Secretary:

Name of Treasurer:

Date of last AGM:

9.Is your organisation a signatory of the Kensington and Chelsea Compact?

YesNo

If not, go to www.rbkc.gov.uk/compact to sign up

Please enclose a copy of your latest annual accounts and annual report.

If a report is NOT available then answer questions 10-12 on the following pages.

You must complete PART 3 Payment Details otherwise grant payment may be delayed.

PART 2

This page to be filled in ONLY if you do not have a report available. If you have enclosed the latest Annual Report with your application you need not complete this section.

10.What are the main aims/objectives of your group?

11.What geographical area does your organisation serve?

12.Describe the activities undertaken by your group in the past year. In the case of new groups, outline activities that are planned.

This page for organisations not already receiving BACs paymentsfrom the Royal Borough.

PART 3BACS Form

It is the Royal Borough’s policy to make all payments by BACS transfer to reduce administrative costs. Please supply the details of your bank account below so that, if you are successful in your grant application, we can make payments quickly by direct bank transfer. Please send a copy of a recent bank statement with this form.

Organisation Name:
Organisation Address:
Fax No.:
Tel. No.:
Payee’s Bank Account Name:
Bank Sort Code: / - / -
Bank Account Number:
Bank Name & Branch:
Bank Address:
Bank Post Code:

Signature:Date: ______

Print Name

Job Title:

Office Use Only:
One World Supplier Number:

Part 4Declaration

  1. I am authorised to make an application on behalf of the above organisation
  2. I certify that the information contained in this application is correct
  3. If the information contained in this application changes in any way I will inform the Royal Borough of Kensington and Chelsea, community Engagement Team
  4. I give permission for the Royal Borough to record the details of my organisation electronically and to contact my organisation by phone, mail or email with information about its activities and funding opportunities.

Name......

Position in organisation......

Signed...... Dated......

Before you submit your application, please check you have you completed the following:

Completed all the questions

Provided annual report and accounts

Provided quotes for equipment

Provided a cashflow is applying for over £7,000

Page 1