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LOCAL INITIATIVES FUND APPLICATION FORM 2018-19

All applications for funding need to demonstrate a clear benefit to the local community

and have a clear set of objectives that can be measured. Please see the Local Initiatives Fund Guidance Notes.

1.Your Organisation

Name of organisation
Main contact person
Position in organisation
Charity Number (if applicable) / Company Number (if applicable)
Organisation’s registered address
Correspondence address
(if different to registered address)
Telephone
Email address
Website (If available)
Are there any Islington councillors connected to your organisation?
(e.g. as a trustee/ board member, employee or volunteer) / Yes ☐ No ☐
If ‘Yes’ please provide the name(s) of the councillor(s) and their position in your organisation

2.Pre-Application Questions

Which ward(s) would you like to deliver your project in?
Which ward(s) would you like to apply to?
Have you contacted the ward councillor(s) to discuss your project? / Yes ☐ No ☐
If ‘Yes’ which ward councillor(s) did you contact?
Have you previously received a Local Initiatives Fund award? / Yes ☐ No ☐
Is the previous Local Initiatives Funded project still running / does some of the grant still need to be spent? / Yes ☐ No ☐
If ‘Yes’ when is the expected end date of this project?
If ‘No’ have you returned the monitoring information for this project? / Yes ☐ No ☐
Does your organisation currently receive any Islington Council funding or have contact with any other Islington Council department(s)? / Yes ☐ No ☐
If ‘Yes’ please provide the name of the council officer(s), the department (s) and details of the funding received
  1. Insurance and Safeguarding Documents

Do you have adequate insurance in place for your activity(e.g. Public Liability Insurance, Employers Liability Insurance and Professional Indemnity Insurance)? Please note that we may ask to see this. / Yes ☐ No ☐
Please state the expiry date of your current Public Liability Insurance policy.
Do you have a Safeguarding Children policy in place? This is essential if your project will involve working with children.
Please note that we may ask to see this. / Yes ☐ No ☐
Do you have a Safeguarding Adults policy in place? This is essential if your project will involve working with adults.
Please note that we may ask to see this. / Yes ☐ No ☐
  1. Your Project

4a. What is the name of your project?
4b. Please provide an overview of the project/event that you want to deliver:
(Maximum 300 words)
Where will your project / event / activity take place?
4c. Which sections of the community will benefit from this project/ event? e.g. women, older people, young people, BME communities:(Maximum 200 words)
How many people will benefit?
How many Islington residents will benefit?
(If applying for more than one ward, please provide the number of beneficiaries for each ward)
4d. Please tell us what your project’s objectives are and how will you know these have been met. e.g. how you will monitor your project:(Maximum 200 words)
4e. Delivery period:
Please note the following for this section:
  • The Local Initiatives Fund normally forward funds projects so ideally the start date of your project should be at least 9 weeks after the application deadline published on the website.
  • Local Initiatives Funding should be spent within 12 months of being awarded. The award date is around 6 weeks after the application deadline.
  • If your project is ongoing, we would like to know the timeframe within which the funding applied for will be spent.

What is the start date? / What is the end date?
Additional information about the timetable of the project / event:
Do you see any issues/ problems with starting and ending on these dates?
3f. Does your project focus on any particular themes? (select all those that apply):
Children and Young People / ☐ / Community Cohesion / ☐ / Employment / ☐ /
Environment/ Greenspace / ☐ / Health and Wellbeing / ☐ / Mental Health / ☐ /
Training and Development / ☐ /
Other (Please specify):
4g. Project Costs
What will be the total cost of this project/event? / £
How much funding are you requesting? / £
Please provide a detailed breakdown of what the Local Initiatives Fund will pay for:
(This may include for example, room hire, staffing costs, equipment costs. Please ensure that you show how you have calculated the costs for each item e.g. Room Hire, £20/week x 50 weeks = £1,000). If you need extra space, please submit the budget on a separate sheet.
Item (e.g. volunteers’ reimbursement - travel expenses and refreshments) / Amount
£
£
£
£
£
£
£
£
£
£
Total amount of Local Initiatives Funding requested: / £
If you have secured or are seeking additional source(s) of funding, please provide details here. Please ensure that the total amount of match funding added to the amount of funding requested equals the total cost of the project/ event (as entered in the two boxes in the table above).
Income/Match Funding Source / Amount / Secured?
£ / Yes ☐No ☒
£ / Yes ☐No ☐
£ / Yes ☐No ☐
£ / Yes ☐No ☐
£ / Yes ☐No ☐
Total amount of match funding: / £
  1. Supporting Documents

Please provide electronic copies of the following documents with your application form if you are an external organisation.

Governance documents: / Previously
provided
up-to-date document? / Attached? / Unable to provide? / Please explain the reasons why you are unable to provide this document.
Constitution (essential) / ☐ / ☐ / ☐ /
Finance and accounting documents:
Annual Audited Accounts or
Accounts signed by Chair or Treasurer (essential) / ☐ / ☐ / ☐ /
Most recent Bank Statement (essential) / ☐ / ☐ / ☐ /

Please email the form and supporting documents before the Local Initiatives Fund deadlines listed on the Council’s webpage

to:

Patricia Keating, Voluntary and Community Sector Development Team, Homes and Communities, Fourth Floor (non-Laycock side), 222 Upper Street, N1 1XR

Office / Councillor Use:
Should this proposal be awarded a Local Initiatives Fund grant? / Yes ☐No ☐
Should this proposal be fully funded? / Yes ☐No ☐
If ‘No’, how much funding would you recommend be awarded to this group? / £
Councillor’s comments on their decision:
Councillor(s) signature to confirm that this project should be awarded Local Initiatives
Funding:
Name(s): / Date:
Councillor’s signature(s):
Declaration of interest: Councillors should declare their interest if they have any connection with an organisation that they are recommending funding for.
I am declaring an interest in this submission as detailed below:
Name(s): / Date:
Councillor’s signature(s):

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