Creative Rural Communities
Local Action Group (LAG)
Project Proposal Application Form
<Applicant to complete>
Section 1:Project title:
Name of business/organisation/network:
Name of lead contact:
Address for correspondence:
Postcode:
Telephone number:
Mobile number:
Email address:
Project address (if at a physical location):
Project postcode:
(If farm) County Parish Holding Number:
(If farm) Farming Connect Membership details:
Who owns the project property/land?
If the property/land is leased, who is the tenant? / How many years remaining on current lease?
Name and address of landlord (if applicable):
Please demonstrate the ownership or land/property agreement for the project:
(You may be asked to supply supporting documents.)
Briefly describethe natureof your business/organisation/network in its current form:
Section 2 - Project summary:
Is this project specific to the rural Vale of Glamorgan? / YES / NO
Or, is this project part of Co-operation project? / YES / NO
Please provide details about your project:
How does it meet the objectives outlined by the LAG?
What evidence do you have to demonstrate that this project is needed?
What support can you demonstrate from other stakeholders/organisations?
Have you sought any advice/business advice, other than from CRC? If yes, please provide details.
How will your project be managed?
Project start date: / Project finish date:
Evidence of match funding: Please provide in detail where your match funding is coming from e.g. grant or cash match funding.
Section 3:
How will the project add value to the area, complimenting existing services/facilities in the area?
What is your marketing plan for the project?
Please demonstrate how the project will address the following cross cutting themes:
1. Equal Opportunities including Welsh language
2. Sustainable development
3. Poverty and Social Inclusion
How will the project be sustainable after the funding period?
Does the project require planning permission? Please provide date planning permission obtained?
Project outputs:
Please estimate the following and provide details:
Adding value to the local identity and natural and cultural resources / Facilitating pre-commercial development, business partnerships and short supply chains / Exploring new ways of providing non-statutory services / Renewable energy at community level / Exploitation of digital technology / Co-operation / Rationale – Please give details
Number of Operations
Number of Businesses Assisted
Number of Communities Assisted
Number of jobs created
Number of Farm Holdings assisted
What realistic and measurable milestones and targets can be put into place to measure the impact of your project?
What do you hope to learn from this project that can be shared with others?
Which of the following do you plan to produce to capture the learning outcomes from the project, and how do you propose to distribute it?
Project report
Presentation
Tool kit
Film
Blog
Other – Please explain
Section 4:
Project costs:
Please provide a breakdown of the project costs by heading for the items or activity per year.
Revenue costs:
Item or activity / 2015 / 2016 / 2017 / Total
Total project cost
Fundsapplied for.
maximum funds available (up to 80 % of total project cost)
Match funding
(at least20% of total project cost)
Section 5
The information which you provide to Creative Rural Communities will be held for the purpose of monitoring and evaluating which is a requirement for the European Commission’s Rural Development Programmes and the Common Monitoring and Evaluation Framework. To enable us to meet our obligations we shall share your information with the Welsh Assembly Government. For further information on how your information is used, how we maintain the security of your information and your rights to access information we hold on you please contact: Victoria Trundle at: The Annexe, Old Hall, Cowbridge, CF71 7AH. Direct line 01446 775118 or via .
I consent to all of the above and declare that the information contained in this application form is correct, and on behalf of ...... …………………………...... (name of organisation) apply for funding of £ ………………… towards the cost of the project described in this application.
Signature: ………………………………...... Date: ………………………
Signature of ‘Authorised Individual’: ………………………………………………………….
Please return the signed and completed application along with supporting evidence to:
Creative Rural Communities, Old Hall, High St ,Cowbridge, Vale of Glamorgan, CF71 7AH
Please supply the following supporting evidencewith the signed application form:
CRN Number
Farming Connect membership (if applicable)
Copies of quotations for project costs
(In line with tendering guidelines)
Evidence of match funding
Approved planning permission evidence
Evidence of your tenancy agreement (if applicable)
Written consent from all business partners (if applicable)
Written permission from landlord for proposed development/activity (if applicable)
Completed Credit Check Form
Section 6Prior to any grant funding being authorised it is necessary for Creative Rural Communities to carry out financial checks on the applicant and/or organisation. The details provided below are checked internally within the Vale of Glamorgan Council to ensure that there are no outstanding debts to the council.
For private business applicants, there is an additional Experian check carried out on individuals / businesses.
Section A
INDIVIDUAL DETAILS(Please complete if you are applying from a private businesses only)
Title / Surname / First Name(s)
Date of Birth
Home Address including postcode
Contact Telephone / Home / Mobile
BUSINESS DETAILS
(Please complete if you are applying from a private businesses only)
Business Name / Registered Number
Business Address including Postcode
Please circle as appropriate / Sole Trader / Partnership / Limited Company / Other
List name of all Directors/Partners if applicable (Please note that each person should also fill in separate form with above details to ensure individual details can be checked.
Please Circle as appropriate…
Are you in partnership with anyone, whether or not in connection with this grant application? / Yes / No
Have you ever been adjudged bankrupt, entered into a voluntary arrangement with your creditors (formally or informally) or been involved in any failed business previously? / Yes / No
Have you ever been convicted of fraud or any other offence involving dishonesty? / Yes / No
Are you sourcing any other public sector funding in relation to this proposed project? / Yes / No
Do you currently have any outstanding debts with the Vale of Glamorgan Council? / Yes / No
If you answered “Yes” to any of the above questions, please provide details. Processing of your application may be delayed as a result of any discrepancies identified between the information provided on the application and any checks undertaken by Vale of Glamorgan Council.
ORGANISATION/BUILDING DETAILS
(Please complete if you are applying from a third sector or public organisation.)
Organisation Name
Organisation Address (including Postcode)
Customer Reference Number (if applicable)
PRIMARY CONTACT DETAILS (This is merely for our information and will NOT be Debt Checked)
Contact Telephone / Home / Mobile
Title / Surname / Forename(s)
Please Circle as appropriate…
Has the Organisation ever been convicted of fraud or any other offence involving dishonesty? / Yes / No
Is the Organisation sourcing any other public sector funding in relation to this proposed project? / Yes / No
Does the Organisation currently have any outstanding debts with the Vale of Glamorgan Council? / Yes / No
If you answered “Yes” to any of the previous questions, please provide details. Processing of your application may be delayed as a result of any discrepancies identified between the information provided on the application and any checks undertaken by Vale of Glamorgan Council.
Section B
The Council will check the applicant’s financial details – depending on whether the applicant is an individual/business or community organisation. The application may be declined or delayed should any information be withheld by the applicant.I grant consent to The Vale of Glamorgan Council to access personal/organisation/facility information held by Council Tax and/or any other Council department for the purpose of verifying the information included in this application.
In addition, I authorise The Vale of Glamorgan Council to make necessary enquiries with other sources, including credit agencies, to verify any information needed to determine this application.
I declare that all of the information given on this form is, to the best of my knowledge, correct and I understand the provision of a false declaration may result in action by The Vale of Glamorgan Council against the applicant for the recovery of the grant made to the applicant plus costs, charges and related expenses
In compliance with the Data Protection Act 1998, Creative Rural Communities are, for the purpose of this application for a Rural Development Plan Grant, granted consent to make enquiries regarding my personal indebtedness to the Vale of Glamorgan. I understand this information will only be used within the context of this grant application.
Using Your Information - Information which you provide will be used:
- To process your application
- To make lending decisions
- For fraud prevention
- For audit and debt collection
- For statistical analysis
Victoria Trundle at: The Annexe, Old Hall, Cowbridge, CF71 7AH. Direct line 01446 775118 or via
Signed / Dated
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