APPLICATION FORM

SECTION 1. APPLICANT’S DETAILS.

Sustainable development in the Cotswolds AONB will promote, enhance (and conserve) the environmental, economic and community well being of the area to ensure an improved quality of life for everyone, now and for future generations.

Details of applicant.

1. Name of organisation

2. Name of applicant

3. Contact Address

Postcode

4. Daytime telephone number

Fax Number

E-mail address

Applicant’s declaration.Please read and sign the following statement:

“I certify that that all the information provided in this application is true to the best of my knowledge. I certify that I am the applicant or I have the applicant’s authority to submit this application. I understand that any misleading statements whether deliberate or accidental could make the application invalid and therefore liable for the return of any money. I also understand that any information submitted will be made publicly available and may be viewed on the Board’s website.”

SignatureDateDate

Name

(in block capitals)

APPLICATION FORM

SECTION 2. PROJECT DETAILS.

About your organisation.

1. Name of Applicant

2. Name of organisation

3. Please provide the following information – tick all boxes that apply:

Voluntary Organisation □

Parish Council□

Public Sector □

Registered charity□Number:…………………………

Private individual□

Private company□

Other (please state)□

YesNo

Does your organisation have a formal constitution?□□

(If Yes, please attach a copy)

Does your organisation have a bank account?□□

Are you registered to reclaim VAT?□□

4 Please give a brief description of your organisation

5. Name of project

6. Location of project (with nearest postcode)

7. Please give a brief description of the project for which you are applying for funding

8. What will be the outcomes of your project and who will benefit and how, i.e. local community, environment?

9. How have you identified the need for your project? (Tell us who has been involved and consulted)

10. How will your project meet the theme and aims of the Sustainable Development Fund (refer to the Sustainable Development Fund website andGuidance notes)?

11. How will your project satisfy the essential criterialisted in the Fund’s guidelines?

12. Which of the desirable criterialisted in the guidelines will the project satisfy, and how?

13. Please list any permissions that are required before the scheme can be implemented e.g. planning or landlord’s / owner’s permission? Please say what is needed and when it will be obtained.

14. Please list all partner organisations, and specify their involvement in the project.

15. Timetable for project:

Proposed project start date (month / year)

Proposed end date (Month/Year)

Key Milestones. / Target date
Project budget

16. Please estimate the cost of your project(only include VAT if you are unable to reclaim it).

Item or works / cash / grant /
in kind / Value £
(ex VAT) / VAT £
Sub totals
Total Project Cost.

17.How would you spend a Sustainable Development Fund grant?

Item or works / Value £
(ex VAT) / VAT £
Total Grant requested (only include VATif you cannot reclaim it). / £
Grant requested as a percentage of total project cost (see Q16 above) / %

18. List any other sources of funding broken down into the following. Please show where VAT is included.

Source (please give full name of organisation) / Applied for/Confirmed/Possible / Cash /
Grant /
In kind / Value £
Amount sought from the Sustainable Development Fund / P / Grant
Total(this figure should be the same as the total in Q16)

19. Will the project generate income? If so, how will this be invested?

Monitoring and evaluating your project.

20. How will you measure the success of your project;and how will you demonstrate that you have met aims and objectives of the project?

Further information.

21. Who will maintain the completed project and how will this be funded in the future?

22. How would you publicise your project and acknowledge SDF assistance?

23. Were you aware of the work of the AONB before making this application?YES / NO

If you have previously received financial or other support from the AONB? Please give details.

Details of any financial or other support (e.g. grants, advice etc) / Date received

24. How did you find out about the Sustainable Development Fund? ………………………….

……………………………………………………………………………………………………………

CHECKLIST

Please ensure that you enclose allrelevant supporting information with your application. This should include;

  • Copy of project business plan (if available)
  • Copy of quotes for all items of expenditure
  • Evidence of support for your project (e.g. letters/email from local community groups)
  • Copy of your organisations most recent year of accounts
Contact Details

Please return this completed application form to: Rural Skills and Grants Officer, Cotswolds Conservation Board, The Old Prison, Fosse Way, Northleach, Glos GL54 3JH.

SDF is delivered locally by the Cotswolds Conservation Board