Local Body Partnership (LBP)–Expression of Interest Form

Personal Details (of the applicant on behalf of the community)

First Name / Click here to enter text. /
Surname / Click here to enter text. /
Full Address / Click here to enter text. /
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Postcode / Click here to enter text. /
Telephone (Landline) / Click here to enter text. /
Mobile Number / Click here to enter text. /
E-mail Address / Click here to enter text. /

Select your situation:

☐ I represent a community who is interested in improving our broadband

☐ I represent a school interested in getting superfast broadband

☐ I represent a business park whose businesses are interested in improving our broadband

☐ I am an individual looking for help on getting better broadband

☐ I am a developer interested in getting fibre broadband for my development

Funding

Has the required community funding been secured?

☐Yes

☐No

Source of Funding

☐Private e.g. residents, fundraising etc.

☐Public e.g. Parish Council funds or public grant funding

Please note, only private funding can be used as a community contribution for LBP.

Potential Future Deployment

Communities understand that once they commit to a Community Fibre Partnership / Local Body Partnership Scheme, they will no longer be considered for deployment as part of the main programme, unless their process is not completed.

☐I understand that once my community has agreed the broadband solution and signed the CFP/LBP agreement, premises in scope for LBP will no longer be considered for any potential future Superfast Worcestershire deployment, unless their process is not completed.

☐I also confirm that I, as the Community Lead, have made my community aware of the above statement.

Full Name / Click here to enter text. /
Position in CFP or Business / Click here to enter text. /
Signature / Click here to enter text. /
Date / Click here to enter text. /

Better Broadband Subsidy Scheme (BBSS) eligibility

Better Broadband Subsidy Schememay potentially be available for eligible premises (sub 2Mbps) to offset the cost of improving the existing broadband network. If successful in securing the voucher, eligible premises will be able to utilise the £350 voucher as their contribution and to reduce the overall cost. Please list all premises that may be eligible for the BBSS voucher. If unsure, please consult BT Broadband Availability Checker:

Full Address including postcode / BBSS Eligible?
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If you need to add more addresses - this section will expand as you type / Eligible Y/N
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Community Fibre Partnership (CFP) Quote

Please provide the reference number for your Community Fibre Partnership quote.

Reference No. / Click here to enter text. /

Disclaimer

Please note that by signing this Expression of Interest Form you agree with and accept the information set out by Openreach in their CFP quote for your community, which you have confirmed by providing the CFP reference number above.

The council does not have the ability to influence expected timescales, the technical solution or quote amount provided by Openreach; neither do the council have control over supplier service charges or monthly subscription charges.

By undertaking a Local Body Partnership the community recognises that if the anticipated cost is below that quoted by Openreach, Worcestershire County Council will retain the 'underspend'; conversely, Worcestershire County Council accepts the risk that if estimated costs increase the Superfast Worcestershire Programme will accept the full additional costs up to the maximum limits of the LBP scheme (£80,000 per community), at which point they will discuss this with the community.

Next Steps

We will protect your personal data and keep it safe. As part of your application for Local Body Partnership (LBP) funding, we need to share your data with BT and Openreach in order to bring your community into the Superfast Worcestershire deployment through the Local Body Partnership Scheme. Your data may also be shared with Broadband Delivery UK (BDUK) to confirm Better Broadband subsidy eligibility. Worcestershire County Council, BT, Openreach, and Broadband Delivery UK (BDUK) may contact you in regards to your application if this is required. We will not share your data with any other organisations without your prior agreement, unless we are required or able to do so by law. Your data will not be used for marketing or any other purposes. Further privacy information is in the Council's full Privacy Notice.

I agree to this information being shared with BT, Openreach and Broadband Delivery UK (BDUK)

☐Yes I agree

If required, I agree to being contacted by:

☐Worcestershire County Council ☐BT ☐Openreach ☐Broadband Delivery UK (BDUK)

Please email completed form to: