Post: SY Fire and Rescue Authority, 18 Regent Street, Barnsley, S70 2HG

PLEASE ENSURE YOU HAVE READ THE SSCR INFORMATION PACK PRIOR TO COMPLETING THIS FORM. THE RESERVE HAS STRICT ELIGIBILITY CRITERIA

Completed forms to be returned to:

Rhona Bywater

Post: SY Fire and Rescue Authority, 18 Regent Street, Barnsley, S70 2HG

Email:

Submission Deadline: Monday 10th February

Funding Expression of Interest Form

1. Key Information

2. Summary

Please provide a summary of your project proposal. Your summary should briefly describe the basis to your proposal and summarise the benefits it will deliver and the outcomes it will achieve.

3. Background

Please describe why you wish to set up this project and summarise the community need you are addressing. Please include a brief outline of any previous activity you have carried out in this area

4. Aims and Objectives

Please describe the intended outcomes of the project; these should fit in with the key objectives of the Stronger Safer Communities Reserve

5. Activities

Please outline the range of activities that the project will deliver. This may be across a large geographical area or more focused on a specific area. Briefly explain how you will monitor and evaluate these activities.

6. Partnerships / Collaboration

Show how you intend to work in partnership with SYFR. This may include collaboration with existing community-led projects / public sector programmes and/or other voluntary groups. Briefly outline how this collaboration will work in practise. What opportunities are there to attract funding from other sources?

7. Project Costs and Outcomes

Please provide an outline of the funding required for the project and a full breakdown. This should not exceed £250.000. Intended outcome information should include numbers of communities, areas or individuals likely to benefit from such an initiative and evidence of any revenue implications.

8. Timescales and Milestones

Please outline the project timescales and milestones. When will the project start and finish and what are the key stages of the project plan. Please also comment on any exit strategy and post-project plans

9. Additional Comments in Support of Your Application

Please provide any further information to support your application

10. Contact Details

11. Declaration

I have read and agree to abide by the Standard Conditions stipulated by the Fire and Rescue Authority.

Signature:Date:

Name: