You Can Complete This Form Online Instead At

Carers GroupGrant

Application Form 2018-19

Cornwall Rural Community Charity’s (CRCC) mission is to enable Cornish communities to be vibrant, sustainable and inclusive. We offer services and information to local groups and individuals.

The Carers Group Grant is one of several grants that Cornwall Council and NHS Kernow have commissioned us to manage on their behalf. The grant aims to fund unpaid, informal carers’ groups to give their members opportunities to ‘switch off’ from their caring responsibilities by taking part in group activities and events that promote their health and wellbeing.

You can complete this form online instead at:

Carers Group Grant Application Form 2018-19

Please ensure that you have read and understood the application Terms and Conditions at the back of this application pack before completing the form.

Please use BLOCK CAPITALS when completing the application form by hand

Section 1 – Contact Information

Have you read and understood the grant terms and conditions that accompany this application form? / Yes [ ]No [ ]
Name of group
Your name / Can we include your name in group publicity? / Yes [ ] No [ ]
Address & postcode
Telephone / Can we include your number in group publicity? / Yes [ ] No [ ]
Email address / Can we include your email in group publicity? / Yes [ ] No [ ]
How did you hear about this grant?
Can we add you to our mailing list to receive our newsletters? / Yes [ ] No [ ]

Section 2 – About your group

Brief description of your group: What does it do? Who is it for?
How long has it been running?
Where does it meet?
What days/times?
How many carers attend your group?
Are your group members supported by Kernow Carers Service (formerly Cornwall Carers Service)? / Yes [ ] No [ ]
Would you like us to send you information about Kernow Carers Service for your group members?They can provide advice and guidance, advocacy, the opportunity to meet with a Carer Support Worker and information about benefits / Yes [ ] No [ ]
Have you had a grant from us before? / Yes [ ] No [ ]
If yes, when was the last time you had a grant from us? Month/ year
Have you sent us your last feedback report and relevant receipts? You will need to send these to us before we can consider your application for another grant / Yes [ ] No [ ]

Section 3 – About your intended activity

Please tell us what you would like funding for. At least 4 people must take part at any one time in funded activities
For activities: where and when will they take place? Must be before 31 March 2019
How many carers will be taking part?
Please tick to confirm all carers benefiting from this grant are aged 18 or over / Carers are 18 or over [ ]
How will the intended activities promote carers’ health and wellbeing and give you/them a break from your/their caring role?

This grant is also able to fund some cared-for persons where carers are not able to attend your group activity unless they can take the person they support with them due to a lack of alternative care arrangements. If any supported persons have to attend your activity with your group members, please tell us about this here.

How many carers in your group could not attend your activity without the person they support?
How many cared-for/supported persons will be attending?

Section 4 – Costings for your activities

Please provide a detailedbreakdown ofallcosts that you would like the grant to fund below, being careful to say specifically what each item is. We need to know ‘what’, ‘where’, ‘how many’, ‘how much’, etc.

Please submit evidence of these costs with your application. We need to know how you worked out your costs so would need you to send us quotes, website addresses, etc. Failure to provide enough detail and relevant evidence of costs could delay your application being considered. If you are unable to do this for any item, please contact our office first to discuss why.

Please check the Terms and Conditions for details of what the grant can and cannot be used for.

How much money are you applying for? Max £70 per person, max £750 per application / £

Please tick against each item to indicate if you are submitting relevant evidence 

Item
E.g. 10 tickets for Hall for Cornwall show @ £32 each / Total cost £ (inc. VAT) / Evidence included(please tick)
Total cost / £
Please use this box to provide evidence of costs, e.g. website addresses. You can also send in additional documents, e.g. quotes, etc, on separate sheets of paper if needed.
Section 5 – Your bank details
If your application is successful, payment will be made directly into your bank account
Name of bank/building society
Bank account name
Bank account number
Sort code
Section 6 - Independent referee
Repeat applicants – if you have applied to us for a grant before, you do not need to give us details of a referee
New applicants – if you have not had a grant from us before, your group must provide a reference. This should be someone, ideally a professional, who knows your group and supports your application for funding, e.g. a Carer Support Worker. This cannot be members of your group or family.
You will need to send the reference to Grants, CRCC, 2 Princes Street, Truro TR1 2ES oremail to . It is your responsibility to ensure we receive your reference before the application deadline.
Referee name
Position (if applicable)
Organisation (if applicable)
Referee address, incl. postcode
Email address (if applicable)
Tel no
How does this referee know your group?

Section 7 – Declaration and agreement

Please tick all boxes to indicate your agreement

I agree to the Terms and Conditions of the Carers Group Grant that
accompany this application form.
I understand that if my group is given a grant, we will only use it for the item or activity stated in this application form. If we need to use the money for something else, we understand we must get permission from CRCC first.
I understand that at least 4 people must take part at any one time in any funded activity.
I understand that if CRCC is not satisfied with how the money has been used we may be asked to repay some or all of the grant.
I am submitting evidence of the costings relating to the items/activity that we are requesting a grant for, e.g. quotes or website addresses, etc.
I understand that this grant cannot be used for items/activities already paid for.
I agree to complete a feedback report on how the grant was spent and how it has helped the group, and agree to send in all relevant receipts. (Feedback reports must be sent back within 1 month of the final grant-funded activity using the template provided.)
I understand that the grant money must be spent by 31 March 2019 and all activities must have taken place before this date.
I understand that if I leave the group, I will ensure that someone else in the group will take responsibility for the grant and inform CRCC of this.
I have read the Data Protection statement in the Terms and Conditions and agree to how CRCC will hold/use my details.
I confirm that the information provided in this application is true and accurate to the best of my knowledge.
Name
Signature
Date

Next steps

Please take a copy of this completed form for your own records. You may need to refer to your application form during the application process and you will need to refer to it when completing a feedback report.

The application deadlines for this year are:

Application deadline / Panel meeting
27 April 2018 / 17 May 2018
22 June 2018 / 11 July 2018
19 October 2018 / 14 November 2018
18 January 2019 / 6 February 2019

Please post to:

Grants, CRCC, 2 Princes Street, Truro TR1 2ES

If you need to call us, our number is: 01872 273952

Our email address is:

Data Protection

Please note by sending in this formwe will keep your details for recording/monitoring purposes, e.g. showing CRCC's work across Cornwall and IOS (no personal details).

We will not share your details with third parties; however we will on occasions contact you with information that we consider relevant/beneficial to your group. We will also contact you every eighteen months to confirm the details we hold are correct.

To help us satisfy the requirements of the General Data Protection Regulations, please confirm that you agree to this by ticking the box in the Declaration/Agreement section above. If you wish to be removed at any time in the future, please contact us 01872 273952.

Additional documentation

Please check that you are submitting the following documentation as required:

[ ] Evidence of all costs, e.g. quotes, website addresses, etc.
[ ] Feedback report and receipts relating to any previous applications if not already
submitted

Carers Support Service

Carers Group Grant

Terms & Conditions and Guidelines

If you need help with your application, please call us on 01872 273952 or email

Purpose of the grant

This aim of this grant is to fund groups of four or more adult carers to take part in group activities and events that promote their health and wellbeing and so help carers remain in their caring role for longer. It can pay for activities or for running costs for carers groups. The grant is intended to support carers to have a short break from their caring responsibilities as part of a group activity. Where a carer would be unable to attend a group activity without the person they care for, the grant can include costs for the supported person.

Terms and Conditions

Eligibility Criteria

Groups must have a minimum of 4 people taking part in the activity/activities at any one time, which can include the cared-for where carers would be unable to attend an activity without the person they support.
Activities must clearly and directly benefit unpaid, informal carers.
Groups must be based in Cornwall and only benefit residents of the county who are aged 18 years or over.
Activities must take place in Cornwall.
Groups can apply for up to £70 per person, to a maximum of £750 per application. Groups can apply more than once per year to a yearly maximum of £1500.

Exclusions (what this grant cannot pay for)

Activities that do not clearly and directly benefit carers and aim to improve their health and wellbeing.
We cannot fund any costs not directly and solely benefiting carers, e.g. general costs for events also open to the general public.
Applications must not exceed £70 per person, £750 per application and £1500 per year.
Activities that are for individual benefit, e.g. haircut, clothing, or other personal items.
Activities where carers will not be participating as part of as group, and where the group activity has less than 4 people taking part.
Activities which will not take place in Cornwall.
Admin costs are not included.
Group facilitation costs are not included.
Overnight accommodation costs are not permitted.
Activities or short breaks for family groups are not included.
Travel expenses are not permitted, including coach hire.
This grant cannot pay for equipment or debt consolidation.
Items and activities already paid for or taken cannot be reimbursed through this grant.
Applications from groups who have had a grant from us before and who have not submitted their feedback report and all relevant receipts.

Guidelines

Completing your application form

Applications must detail how the grant will directly and solely benefit carers’ health and wellbeing.
You must provide a reference, ideally from a professional, that supports your group’s application.
Please list all costs for which the grant is required. Check the above Eligibility Criteria and Exclusion to ensure your costs are permitted.

Additional documentation

Evidence of listed costs must be submitted with your application, e.g. receipts from previous applications, quotes, invoices, website addresses, etc.
If you have applied to this grant before, we must have received a feedback report and relevant receipts from you before we can process your application. If you have not already submitted your report and receipts, please send with this as soon as possible to avoid a delay in processing your application.

Data Protection

Please note by sending in this formwe will keep your details for recording/monitoring purposes, e.g. showing CRCC's work across Cornwall and IOS (no personal details).

To help us satisfy the requirements of the General Data Protection Regulations, please confirm that you agree to this by ticking the box in the Declaration/Agreement section of the application form. If you wish to be removed at any time in the future, please contact us 01872 273952.

Next steps

Once we have received your application we will check it meets the above criteria; we may contact you by telephone to discuss the application in more detail. Therefore please ensure the contact provided is available during office hours and has knowledge of your group. We recommend that you take a copy of your application form, as you will need to refer to it if we have any queries and when completing your feedback report. Following this initial check, your application will go before the grant panel who will decide on its suitability for funding.

The application deadlines for this year are:

Application deadline / Panel meeting
27 April 2018 / 17 May 2018
22 June 2018 / 11 July 2018
19 October 2018 / 14 November 2018
18 January 2019 / 6 February 2019

How your application will be assessed

The grant panel will meet approximately 3 weeks after each deadline to assess applications. The panel members assess each application using a checklist based on the grant eligibility criteria and exclusions.

Priority will be given to:

groups applying for the first time to us.
those that demonstrate good value for money, e.g. greater number of beneficiaries.
applications where the grant request falls below the maximum permitted.

You will receive the result of your application in writing within 7 working days of the assessment and, if successful, an offer letter will be sent outlining any conditions of your grant. Decisions by the panel are final and there is no right of appeal.

Change of grant use

The grant must be spent for the approved purpose and failure to do so could result in a request for funds to be returned. If your circumstances change and you wish to amend your original activity, you must notify CRCC in writing detailing the proposed change and await approval by the Grant Manager before proceeding with the new activity.

Feedback report

Applicants must agree to complete a feedback report at the end of the grant-funded activity on a standard form supplied by CRCC. Your feedback is used by us to report back to Cornwall Council and NHS Kernow on the progress of the grant programme.

Therefore reports must be completed no later than 4 weeks after your activity. When returning the form please include copies of receipts and invoices obtained for all items purchased. No further grant applications will be considered until this has been received and approved by CRCC.

Need more information?

If you need more information please contact:

CRCC

2 Princes Street

Truro

Cornwall

TR1 2ES

Tel: 01872 273952

Email:

Cornwall Rural Community Charity

CRCC is a Cornish charity that informs and guides local groups and individuals to achieve their aspirations and develop sustainable, inclusive communities. CRCC provides support to a wide variety of groups and individuals and embraces equality and diversity. For more information on our work, visit

Carers Group Grant 1 CRCC charity number 1087550