Project Ref No. (Office use)……………

Summer Activities Fund 2018

Name of contact:
Name of organisation:
Type of organisation (please circle): / Voluntary Charity Parish Council Not for Profit Organisation
Other – please state______
Address:
Telephone:
Email:

OUTLINE OF PROJECT

1.  What will your sessions/activities consist of? (Please describe)

2.  Who will deliver the sessions/activities? (Including any partners you will be working with to deliver this activity)

3.  Please detail: (If successful this information will be used in the Borough Bulletin to promote your activity. Please ensure the following information is included and is accurate.)

.

4.  How will you ensure that your activities are ‘open for all’, safe, fun and sustainable?

5.  Number of Young People.

Number of children and young people you expect to engage in your project aged 6-11 years

6. Please state the Anticipated Budget for the project (you may be required to give proof of expenditure if successful)

Project Expenditure and In-kind Costs
Staffing Costs
Date / Number of Staff / Type of Staff / Total Staff Hours / Rate of pay / Funding Requested
Facility Costs:
Date / Facility / Address / Total Hours / Rate of Pay / Funding Requested
Other Costs:
Date / Expenditure Details / Funding Requested
Please state here match funding and or income from other Sources including in-kind (please specify from where and how this won’t ‘double fund’ the project)
Total Project Funding Requested / £

Organisation standards check list

To be eligible for Summer Activities funding your organisation must confirm it meets the following standards:

Standards / Tick to confirm
The organisation has effective Safeguarding procedures in place, with staff and volunteers having appropriate Disclosure Barring Service (DBS) checks or equivalent.
Please Note: A copy of the appropriate DBS checks for all staff involved in the project must be provided on submission of the application form.
The organisation can demonstrate a commitment to equality of access and opportunities that are ‘open to all’.
Premises, staff, volunteers and users are appropriately insured for the activities delivered.
Please Note: A copy of relevant insurance documents must be provided on request.
The organisation can demonstrate appropriate and effective Health and Safety practice, which it uses to ensure safety for children, young people, and others associated with the project.
The activities will be staffed by appropriately skilled, experienced workers, with appropriate qualifications where necessary.
Please Note: We may ask to see a copy of staff training and qualification certificates.
The organisation has a bank account (payments cannot be made to any individuals’ personal bank account) and can monitor and provide evidence of expenditure to show that any grant is being spent correctly.
The organisation agrees to complete project monitoring and evaluation as requested.

Hinckley and Bosworth Borough Council reserve the right to challenge and investigate the validity of these statements and may refuse to fund a project if they are not satisfied.

Deadline 23rd March 2018

SIGNATURES

I declare that:

a)  to the best of my knowledge the information given on this application is accurate

b)  I understand that the information provided in this form may be circulated and discussed with any person or organisation helping to evaluate our project.

c)  All project monitoring & evaluating documents will be complete by the stipulated deadline.

d)  If successful, this project will be promoted and branded as part of the Snapdragon Children and Families Festival. All promotional material will reflect this.

Name Position

Signed Date

Summer Activities Fund Application form 2018 Page 4 of 4