GoFor It Grants

Bringing More Activities to Life. Get Involved in Newham

Application Form

This form will be used to assess your application for a Go For It grant.

It is essential that you read our guidance notes before completing this form.

If you need help or advice to complete your form please contact us and we will be happy to help. Please complete all relevant sections to make sure your application is assessed as quickly as possible.

PLEASE NOTE: If the required documents are not attached, the assessment of your application will be delayed.

OFFICEUSEONLY

Ref:GFIRequest: £

PleaseuseBLACKinktocompletethisform

Thisformmayalsobecompletedon-lineatwww.newham.gov.uk/goforit

PART A – ABOUT YOU, THE PERSON WE WILL CONTACT REGARDING THIS APPLICATION

TitleMr Mrs Ms Miss Dr Other

Firstname

Surname

Telephoneno. Mobile

Emailaddress(ifyouhaveone)

Postaladdress

Postcode

Nameofgroup(ifapplicable)

Yourpositioningroup(ifapplicable)

Websiteaddress(ifapplicable)

Ifweneedtocontactyou,arethereanyspecialcommunicationrequirements?

Yes No Ifyes,pleasespecify

PART B – ABOUT YOUR IDEA

PROJECTDETAILS

Nameofyourproject Pleasedescribewhatyouwanttodo.

Wherewilltheactivitytakeplace? Whenwillyouractivitystart? Whowillbenefitfromyourproject?Pleasegiveussomedetailsaboutnumbersofpeopletakingpart,wheretheylive,agegroupsetc.

BENEFITSOFYOURPROJECT

Whatwillbetheoutcomesorimpactofyourprojectforlocalpeople?

HowdoyouplantomaintainyouractivityafterGoForItgrantfundinghasbeenspent?

RESEARCHANDMARKETING

Howdoyouknowyourprojectisneeded?

Howwillpeoplefindoutaboutyourproject?HowwillyouensureitisopentoresidentsfromthroughoutNewham’sdiversecommunity?

MONITORING

Howwillyoubeabletoshowthatyourprojectissucceeding?

Pleaseprovidecleardetailsonthecostsofyourproject

PROJECTCOSTS

(PleasenotetheGoForItgrantsprogrammewillnormallyawardsmall-scaleone-offgrantsuptoamaximumof£1,000.Exceptionalfundingmaybeawardedupto£2,000ifthereisclearevidenceofsustainabilityinthefuture)

WhatamountareyourequestingfromtheGoForItgrantsprogramme?£

Isthisamountthefullcostofyourproject?YesNo

Ifno,whatisthefullcostoftheproject?£

Howmuchhaveyoualreadyraised?£

Ifthereisanyshortfall,howwillyouraisetherestofthemoney?

Haveyouapproachedanothergrantawardingbodyforthisproject? Yes No

Ifyes,whatisthenameofthisgrantawardingbodyandwhendoyouexpecttoheartheirdecision?

Willyoubechargingserviceusersforyourproject?YesNo

Ifyes,pleasegivedetailsofproposedcharges

PROJECTCOSTBREAKDOWN

PleasetellushowyouplantospendtheGoForItgrant.Pleaselistindetaileachitembelow.Youwillneedtoincludeanestimate

orquotefromyoursupplierswithyourapplicationformforanyitemonyourlistthatexceeds£150,whetherit’sforstaffing,services, equipmentoranyothercosts.

ITEM / DETAILS / COST
TOTAL£

GRANTPAYMENTARRANGEMENTSFORSUCCESSFUL APPLICATIONS

Doesyourgrouphaveitsownbankaccount?Yes*No**

Ifyespleasegivetheauthorisedsignatoriesforyourbankaccountandstatetheirpositioninyourgroup?

Signatory’sname Positioningroup

Signatory’sname Positioningroup

Signatory’sname Positioningroup

*Please provide your organisation’sbank account details on letter headed paper.See page 9 of the guidance notes.

Ifyoudonothaveabank/buildingsocietyaccountinthenameofyourprojectorgroup,doyouknowofanorganisation

thatwouldreceiveagrantonyourbehalf**?

Yes No

Ifyes,pleasegivetheorganisation’snameandphonenumber

Name Phone

**Pleasedonotworryifyoucannotidentifyanorganisationthatwouldassistinthisway,wewillmake arrangements with youforpaymentifyourapplicationissuccessful.

InformalgroupsofresidentsdonotneedtocompletepartsDandE.PleasecompletepartFandthechecklistinPartG.

PART D – ABOUT YOUR GROUP

Tobecompletedbyconstitutedvoluntarygroupsandorganisationsonly.

Pleasedescribewhotakespartinyourgroup,whatyoudoandtheservicesyoualreadyprovide.

Howdoyoupromoteequalopportunitiesandinvolveserviceusersintheoperationofyourgroupandactivities?

Whatdatedidyourgroupstart? InwhichpartofNewhamdoesyourgroupwork?

Isyourgrouparegisteredcharity?YesNo

Ifyes,whatisyourcharityregistrationnumber?

Isyourgroupacompanylimitedbyguarantee?YesNo

Ifyes,whatisyourcompanyregistrationnumber?

Youranswersinthissectionwillprovidecleardetailsofthefinancialsituationofyour group(ifapplicable).

GROUP’SFINANCES
Hasyourgroupproducedannualaccounts? Aretheseaccountsaudited?
Doesyourgrouphaveanyreserves? / Yes
Yes
Yes / No
No
No

Ifyes,pleasespecifytheamount£

Ofthesereserves,howmuchisrestrictedorunrestricted?

Restricted:£ Unrestricted:£

HaveyoureceivedanyfundingfromNewhamCouncilinthelastthreeyears?YesNo

Ifyes,pleasegivedetails

PART F – COMPLETION OF APPLICATION

Thepersonnamedbelowmusthaveapprovalforsubmittingthisapplicationfrom theirmanagementcommitteeorTrustees,orfromtheirfellowprojectorganisersifan informalgroup.

‘Iherebycertifythattheinformationcontainedinthisapplicationiscorrectandinaccordancewiththebestinformationavailableto me,andIundertaketoprovidesuchadditionalinformationasNewhamCouncilmayrequiretoconsiderorverifytheapplication.I furtherconfirmthatiftheapplicationissuccessful,infullorinpart,wewillcomplyfully withthegrantsprogrammeconditionsofgrantaid.’

Name(incapitals)

Position(ifapplicable)

Date

PLEASENOTE

Informationinthisformwillbeusedforassessmentandmonitoringpurposes.Detailswillberecorded onadatabase,whichwillbesharedwithotherofficersinthecouncil,andtogathergeneralinformation thatmaybemadepublic, with due regard for Data Protection Regulation.

PART G - CHECKLIST

APPLICATIONSFROMINFORMALGROUPSOFRESIDENTS

Youmustincludethefollowingdocumentswiththisapplication,whereapplicable.Pleasetickifenclosed

Yourprojectstatementofaimsandobjectives,ifnotstatedinyouranswerstopartB Estimatesorquotesforanyitemsinyour budgetexceeding£150invalue

Namesandaddressesofprojectorganisers(minimumofthreeNewhamresidents)

Ifyouareproposingtopayacoach, trainer,instructororotherproject leader,pleaseenclosetheirCVaswellasdetailsof theirproposedcharges

APPLICATIONSFROMVOLUNTARYORGANISATIONS

Youmustincludethefollowingdocumentswiththisapplication,whereapplicable.

Yourrules, Articles of Association,orconstitution

Yourlatestannualaccounts/financialstatement

Estimatesorquotesforeachiteminyourbudgetexceeding£150invalue

Ifyouareproposingtopayacoach, trainer,instructororotherproject leader,pleaseenclosetheirCVaswellasdetailsof theirproposedcharges

Yourequalopportunitiesor diversity statement

Yourchildprotectionpolicy(whereapplicable)

Namesandaddressesofyourmanagementcommitteemembers

Yourgroup/organisation’sbankdetailsonasheetofheadedpaper(Seepage9oftheguidancenotes).

PLEASENOTE:Ifyourrequireddocumentsarenotattached,considerationofyourapplicationmaybe delayedbeyondtheeightweektargettimescalefordecisionsonGoForItGrantApplications.

IfanyofthesedocumentshavebeensubmittedtotheGrantsTeampreviously,andremainunchanged, thereisnoneedtosendthemagain.

PLEASESUBMIT YOURCOMPLETEDAPPLICATIONTO:

or post it to:

GoForItGrants,LBNCommunityGrantsTeam,NewhamDockside,

1000DocksideRoad,LondonE162QU

Ifyouwouldliketodiscussthisapplicationorneedanyhelpwithanythingrelatingto

GoForItgrantsprogrammepleasephoneuson02033736019

PLEASE SEND YOUR COMPLETED APPLICATION TO:

Go For It Grants, LBN Community Grants Team, Newham Dockside,

1000 Dockside Road, London E16 2QU