Programme Development Fund

SENCE VALLEY ENVIRONMENTAL

IMPROVEMENT FORUM

APPLICATION FORM

Please complete the form fully, using additional sheets where necessary (the information boxes will extend as you type).

Organisation:
Address:
County: / Postcode:
e-mail: / Telephone:

Please describe your organisation’s aims and financial structure (please include a copy of your constitution (or similar) and your most recent accounts or bank statement).

Details of Proposals

Objectives: Please tick which of the following objectives that your project will contribute to.

Tree planting
Landscaping
new and improved public access (for example footpath/cycle links)
provision of new green spaces (including purchase of land where necessary)
creation and protection of wildlife sanctuaries and habitats
other work classed as environmental improvements, please list:
 ......
 ......
 ......

Proposals: Describe your project and how it will deliver the objectives you have ticked above. Please indicate the aims of the project, its time table and how it will be delivered.

Project Title –
Estimated start date: / Estimated finish date:

Benefits: Please indicate the specific benefits of your project to local community and how you will measure its outcomes.

Specifications & Costs

Item / Description / Cost (Net of VAT)
VAT can be reclaimed*
VAT can be reclaimed by us and has not been included in our calculations, all costings have been given to us excluding the VAT / VAT: / £
Total cost: / £
*If any VAT element can be reclaimed by you, exclude it from the bid. / Funding requested: / £

Applicants Resources (Match funding)

Please say where the remaining funds will come from, including grants requested or obtained from other organisations. Include in-kind contributions (as appropriate and eligible).

For continuing long-term activities, please indicate how the activity is intended to be funded this funding ends.

Site Management Proposals

If you are applying for a grant towards the management or development of a site, please indicate whether you have a separate management plan or the equivalent for the site.

Name of site:
Location:
Area in hectares:

Applicant's legal interest in site (e.g. freehold, leasehold, agreement).
Note: If Leasehold or agreement, give details.

If the site is not owned by the applicant, please provide the owner's name and address.

Is the site a: /  / A designated site for wildlife (e.g. SSSI, LNR, local wildlife site)?
 / A designated/listed site for historic or archaeological interest?
 / Other? Please describe:
Does any element of the project require planning permission or any other form of statutory consent (e.g. drainage, licence to cultivate)? / Yes
No

Additional information in support of the proposal.

Declaration

To the best of my knowledge the information supplied with this application is correct.

Signed:
Position (e.g. Secretary, Clerk ,Landowner):
Date:

Please list any enclosures sent with this application.

1:
2:
3:
4:
5:
6:

Checklist

Have you given all the information required?

 / Signature and date
 / Other funding
 / Development and/or the management plan
 / Objectives and timetable
 / Site details
 / Specifications and cost
 / Maps and plans

Please return this form to by email and by post to:

Email –

Signed original copy

North West Leicestershire District Council
Community Focus Team
Council Offices

Coalville

Leicestershire
LE67 3FJ

If you have any queries about the application process, please contact us on 01530 454769.

Application deadline: 31 March 2014

However applications can be submitted before this date (smaller funding requests and those that are time sensitive or with confirmed match funding may be considered earlier) - applicants will be notified of potential timescales on receipt of the application.

The funding is managed and administered by North West Leicestershire District Council, who remains the legal and financially responsible organisation for this fund.

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