Neighbourhood Fund Application Form

Save my progress and resume later | Resume a previously saved form

Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Your Email:

A Password:

Confirm Password:

Password must contain the following:

12 Characters
1 Uppercase letter
1 Lowercase letter
1 Number
1 Special character

IMPORTANT INFORMATION

Please read the funding programme guidance available on our website BEFORE completing your application.

All fields marked with a red asterisk are compulsory fields and must be completed.

To SAVE your work click 'Save my progress and resume later' either at the top or bottom of the form.
After entering a password you must click SAVE - you will then receive an email with a link to your saved form.
We recommend you save your work regularly - avoid leaving unsaved work open on your computer if you stop working on the application.

When you have finished your application click 'SUBMIT' at the bottom of the form.
You will receive an email confirming you have submitted the form.

If you experience any difficulties please contact Grants Manager Ellie Maguire on 07592 032666 or email grants@dorsetcf.org

Section 1 - Organisation

Organisation Details

Name of organisation - This should be the name of the organisation as it appears on your governing document address of the organisation.

Name Of Organisation

Address - This should be the address of the organisation. If the organisation doesn't have a independent location you can use the contact details of the primary contact.

Street name and number

Town/city

County

Postcode

Contact details

General/Office Telephone

The telephone number should be one at which the organisation is easily contacted, especially during office hours.

General/Office Email

The email address should be one at which the organisation is easily contacted, especially during office hours.

Website

Main Contact Details

These are the details that will be used for correspondence purposes and is the person we will contact if we have any queries. The contact person should therefore be someone who has a good knowledge of the application.

Title

Forename/s

Surname

Job Title

Contact details

Work/Office Phone

Home Phone

Mobile Phone

Use Organisations Address For Correspondence

Yes

Main Contact Details

Address Line 1

Town/City

Postcode

County

Organisation Start Date

Organisation Start Date - Month

Organisation Start Date - Year

What Type of Organisation Are You?

Registered Charity (including CIO)

Yes

If yes, please enter Charity Number

Company limited by guarantee

Yes

Company Number

Unincorporated Club or Association

Yes

Community Interest Company

Yes

CIC Number

Other

Yes

If Other, Please Specify

Staffing and Volunteers

Full Time Staff/Workers	Part Time Staff/Workers
Management Committee	Volunteers (Excluding Management Committee)

Bank details

Bank account name

Bank sort code

Bank account number

Governance and objectives

Are you part of a larger regional or national organisation

YesNo

Please provide the name of the larger organisation you are a part of, and tell us how the organisations are linked. (100 words)

E.g. is the larger organisation ultimately responsible for the work of your organisation? Or are you an independent organisation with membership of a wider group of organisations?

Please confirm you have at least 3 unrelated people responsible for running the organisation (e.g. for registered charities these are your Trustees, for Companies these are your Directors), and a bank account in the name of the organisation with at least 2 unrelated signatories required for payments

YesNo

Please tell us which of the above requirements your organisation does not meet

we have less than 3 unrelated people responsible for running the organisationwe do not have a bank account in the name of our organisationour bank account allows a single individual to make payments

What was your total income over the last accounting year?

Please describe the activities or services your organisation provides and who your work is designed to support. (150 words)

This might include a description of how you involve the people you seek to support in the design, development or running of your services.

Section 2 - About your funding request

Details of activities for which funding is requested

Please provide a 20 - 30 word description of the activities you are seeing a grant towards

Project/Funding Start Date

Project/Funding End Date

Which Local Authority will the activities take place in?

Which area or localised region (estate, town, borough) do most of the people who will benefit live?

Please provide a postcode which represents the geographic area where most of your beneficiares live

If there are multiple places please just pick one. If it is too difficult to distinguish please provide the postcode of your organisation.

What social issues will your work address, what are the needs of the people you will support and how have you identified these needs? (250 words)

How will you spend this grant to address these needs? If you are requesting a contribution to your organisation core costs please provide an overview of all planned activities. If you are requesting funds towards a particular service/activity/, please tell us the practical details of what you will deliver e.g. types and frequency of activity, where and when the work will take place. (250 words)

Please describe what you will deliver during the grant period as clearly as possible, and try to avoid getting your description lost amongst lots of context and background information.

What are the outcomes you hope to achieve with this funding? (250 words)

Please focus on the positive changes people will experience in their lives as a result of the funded activities. If the grant will help you to achieve any organisational outcomes please describe these as well.

How will you measure and report on the positive changes made? (200 words)

It is important to have appropriate monitoring processes in place so that you can measure and report on the outcomes of your work in your End of Grant report. However, we do not expect complex or multiple methods.

What plans might you have to continue this work after the grant comes to an end, or do you see it as a one-off project? (100 words)

This can be difficult to answer - please provide any initial thoughts on possible plans and ambitions.

Is there anything else you wish to tell us that is not covered elsewhere in this application form? (200 words)

This is an opportunity to tell us anything else that you think might be relevant to your application.

Section 3 - Impact

Beneficiaries

Which category best describes the overall impact the funded activities will have

How many people will directly benefit from this funding?

This is the number of people who will benefit from direct participation or involvement with your service/activity

How many volunteers will be involved in delivering the funded activities?

Number of other people benefiting indirectly

This is the number of additional people benefiting indirectly, which may include a wider community e.g. friends and family members of participants

Beneficiaries

Primary beneficiary

Other Beneficiaries

Age groups

Primary Age Group

Other Age Groups

Issues

Primary Issue

Other Issues

Activity

Primary activity

Other activities

Outcomes and Indicators

Outcomes are changes and benefits experienced by beneficiaries in their lives. Please select a minimum of 1 and a maximum of 3 outcomes that reflect the aims of the activities for which you are requesting funding

Outcome 1

Outcome 2

Outcome 3

Indicators are measurable signs that help you monitor how far the outcomes have been achieved.
Please select at least 2 indicators for each outcome you selected, that you will be able to measure if your application is successful

Improved Aspirations for the future - choose at least 2 indicators that you will measure

Number of people completing trainingNumber of people on the pathway to self employmentNumber of people reporting an increase in personal aspirations and goalsNumber of people reporting increased literacy and/or numeracy skillsNumber of people reporting increased practical skillsNumber of people reporting that they feel better prepared for workNumber of people taking up work or volunteer placement/experience opportunitiesNumber of people who gained an accredited qualificationNumber of people who went into further and/or higher educationNumber of people whose engagement in education/learning has improved

Improved community cohesion - choose at least 2 indicators that you will measure

Number of people reporting a reduction in feeling that they have been discriminated againstNumber of people reporting an increased awareness and understanding of other culturesNumber of people reporting increased knowledge of their rights and the lawNumber of people reporting that the community facilities were improvedNumber of people reporting that they feel able to enforce their rightsNumber of people reporting that they feel able to have a say in the decisions that affect themNumber of people reporting that they feel an increased sense of belonging in their communityNumber of people reporting that they feel safer in their communitiesNumber of people supported as victims of anti-social behaviour or crimeNumber of people volunteering regularlyNumber of people who took action in a campaignNumber of people who took part in consultation and/or research activities

Improved economic wellbeing - choose at least 2 indicators that you will measure

Number of people receiving emergency suppliesNumber of people receiving new or additional benefits to which they are entitledNumber of people reporting a reduction in debtNumber of people reporting a reduction in reliance on benefitsNumber of people reporting increased understanding of money managementNumber of people reporting that they have an increased ability to heat their home and stay warmNumber of people who became self-employed or gained employment

Improved mental health and wellbeing - choose at least 2 indicators that you will measure

Number of people reporting a reduction of stress, anxiety and/or symptoms of depressionNumber of people reporting improved mental health or wellbeingNumber of people reporting increased interpersonal (social, communication and relationship) skillsNumber of people reporting increased resilience and/or self-careNumber of people reporting increased self-esteem and confidenceNumber of people reporting reduced substance misuse and addictionsNumber of people reporting that they feel better able to maintain healthy relationships

Improved or expanded local environment and/or public space - choose at least 2 indicators that you will measure

Area (hectares) of natural space maintained or improvedArea (hectares) of natural space restored or createdNumber of people reporting increased awareness, understanding and support for conservationNumber of people reporting that the community facilities were improvedNumber of people using community facilities

Improved physical health and wellbeing - choose at least 2 indicators that you will measure

Number of people accessing services to adapt or improve their homeNumber of people participating in sport, exercise and leisure activitiesNumber of people reporting improved access to healthy foodNumber of people reporting improved physical health or wellbeingNumber of people reporting improvements in their diet to be more healthy and balancedNumber of people reporting that they are more physically active

Increased digital inclusion - choose at least 2 indicators that you will measure

Number of people who report improved digital literacyNumber of people who report increased use of online resourcesNumber of people with improved online access

Increased organisational capacity - choose at least 2 indicators that you will measure

Amount of additional funding leveraged as a result of grantIncreased amount of core fundingNumber of existing partnerships developed/strengthenedNumber of new partnerships establishedNumber of new staff employed as a direct result of the grantNumber of new volunteers as a direct result of the grantNumber of Strategic and/or Business Plans developedNumber of Theories of Change and/or Evaluation Frameworks developed

Reduced carbon footprint (i.e. waste, emissions, energy) - choose at least 2 indicators that you will measure

Number of people reporting a reduction in car useNumber of people using more sustainable transport, e.g. public/community transport, cycling, walkingNumber of tonnes of waste diverted from landfillNumber of units of energy (kWh) generated from renewable sourcesNumber of units of energy (kWh) saved

Reduced levels of homelessness for individual people - choose at least 2 indicators that you will measure

Number of evictions avoidedNumber of people accessing advocacy servicesNumber of people moving from sheltered accommodation to independent livingNumber of people moving from street homeless to sheltered accommodation or independent livingNumber of people referred to and accessing other advice/support servicesNumber of people supported to achieve independent livingNumber of people supported to maintain a tenancy

Reduced offending / anti-social behaviour - choose at least 2 indicators that you will measure

Number of people reporting that they are less likely to commit anti-social behaviourNumber of people reporting that they are less likely to re-offendNumber of people reporting that they feel safer in their communities

Reduced social isolation - choose at least 2 indicators that you will measure

Number of people attending activity sessionsNumber of people reporting better access to services or supportNumber of people reporting improved social networksNumber of people reporting that they feel an increased sense of belonging in their communityNumber of people reporting that they feel less lonelyNumber of people volunteering regularly

Section 4 - Budget

Itemised Budget

Please complete the relevant itemised budget sections, to indicate the costs of the activities for which funding is requested. For each section, please tell us:

the total cost
the amount requested (this may or may not be the same as the total cost)
what this will cover

If you are requesting a contribution to your overall annual expenditure, the total cost for each section should be your expected annual expenditure.

Staff Costs

Staff Costs - Total Cost

Staff Costs - Requested Amount

Staff Costs - Breakdown

Volunteer Costs

Volunteer costs - Total Cost

Volunteer Costs - Requested Amount

Volunteer Costs - Breakdown

Operational/Activity Costs

Operational/Activity Costs - Total Cost

Operational/Activity Costs - Requested Amount

Operational/Activity Costs - Breakdown

Overheads, Office/Premises Costs

Overheads, Office/Premises Costs - Total Cost

Overheads, Office/Premises Costs - Requested Amount

Overheads, Office/Premises Costs - Breakdown

Capital Costs

Capital Costs - Total Cost

Capital Costs - Requested Amount

Capital Costs - Breakdown

Publicity Costs

Publicity Costs - Total Cost

Publicity Costs - Requested Amount

Publicity Costs - Breakdown

Other Costs

Other Costs - Total Cost

Other Costs - Requested Amount

Other Costs - Breakdown

Total costs

The form has calculated the totals below based on your itemised budget. Please make sure these figures are correct and make changes to your itemised budget if needed.

Total cost of the activities

If you are requesting a contribution towards your overall annual expenditure, this figure should reflect your annual expenditure

Total amount requested

The maximum you can request is £5000

Other funds raised

Amount secured towards the activities so far

Please give details of funding secured so far

Please provide details of any other funding you have secured for this work. Please include: the name of the funder or source of the funding; the amount secured. We cannot assess your application without this information.

Amount pending, or to be raised during grant period

Please give details of any pending grant applications or plans to raise funds during the grant period

Please provide details of any pending funding applications or other funding you are seeking for this work. Please include: the name of the funder or source of the funding; the amount you are applying for or expect to achieve, and the date you expect to receive the decision. We cannot assess your application without this information.

Section 5 - Supporting Documents

Supporting Documents

Please upload the following required supporting documents or indicate if you prefer to send them separately by email (please note, they need to be received by the application deadline)

If you have sent supporting documents in the last 6 months, you only need to attach a recent bank statement, and your accounts if these are more recent.

Constitution/governing document.

Recent bank statement no more than 3 months old. This can be a scanned paper statement, or a copy downloaded from an online account.

We need to see the bank name, your organisation name, the address where statements go, date of statement, the account number and the sort code. You may obscure transactions if needed.

Latest annual accounts, or in the case of new groups, please send any record of income & expenditure so far, or your financial forecast/budget for your first year if you have one.

Safeguarding policy.

EDI (Equality, Diversity & Inclusion) policy.

Documents to Follow by email

Yes

Section 6 - Consent

Please tick the Declaration underneath to indicate you have read and understood the following Grant Terms and Conditions

Grant Terms and Conditions

1. The organisation and main contact details, and the details of the grant, can be shared with our umbrella body, UK Community Foundations (UKCF), and Wessex Water Foundation, who provide the funds for this programme.

2. The grant recipient must promptly notify and repay immediately to Dorset Community Foundation (DCF) any money incorrectly paid to it either as a result of an administrative error or otherwise. This includes (without limitation) situations where the grant recipient is paid in error before it has complied with its obligations under the Terms and Conditions.

3. The grant can only be spent as stated in the grant application and for no other purpose, unless you have written approval from DCF to use the grant for any other purpose than that stated in the application form. DCF reserves the right to require repayment of the grant (or a relative proportion) if the grant is not used for the purpose and activities as stated in the grant application or subsequent written agreement from DCF.

4. The grant must not be used to fund items or activities retrospectively.

5. The grant funded activities must not be designed to, or include elements that are designed to influence people’s religious or political choices.

6. The grant applicant must start the funded project within 6 months of receipt of funds and complete within 12 months of receipt of funds. Extensions may be requested but remain at the discretion of DCF.

7. The grant recipient agrees that it will not apply for, obtain or accept Duplicate Funding in respect of any part of the funded activities for which the grant has been paid. Duplicate Funding means funding provided by a Third Party to the grant recipient, which is for the same purpose for which the Grant was made but has not been declared to DCF. This includes payments for the same expenditure items from government support mechanisms. DCF reserves the right to require repayment of the relevant proportion of the grant if the project has received duplicate funding.

8. Any funds remaining after the end of the grant period and any agreed extensions, must be returned to DCF.

9. DCF do not commit to renew or continue financial support to you after the Funding Period has ended.

10. You must comply with the 2018 Data Protection Act and UK General Data Protection Regulation. You must comply with all current legislation relating Safeguarding, including Safeguarding of children and vulnerable adults and must adhere to relevant Safeguarding policies at all time. This includes ensuring all paid staff and any volunteers working with children and vulnerable adults have had the required Disclosure and Barring Service (DBS) checks and you can evidence this if requested. DCF may ask at monitoring visits about Safeguarding practice, including any recent incidents and how the policy was followed – funded groups must provide open and honest responses to these queries.

11. Receipts for items of expenditure should be retained for at least 6 years and submitted to DCF if requested e.g. by our auditors or by any grant verification process.

12. Grant recipients are required to complete an End of Grant Report, to include the monitoring of outcomes. The End of Grant Report is to be returned to DCF no later than 4 weeks after the end of the grant period (12 months from the date the grant is received) or as soon as the funded activities are completed. DCF reserve the right to recall the grant if an End of Grant Report is not received. Failure to submit the form will negatively effect future applications to DCF.

13. If agreed to be appropriate, DCF and Wessex Water Foundation will use the project for the purposes of publicity. Your publicity must recognise DCF and Wessex Water Foundation. You will be required to use the DCF logo and Wessex Water Foundation in any publicity related to this grant/activity. Please see ‘Promoting Your Grant Award’ http://www.dorsetcommunityfoundation.org/promoting-your-grant-award/

14. We reserve the right to recover the Grant in whole or in part or to reclaim any equipment purchased under this agreement, should the project or organisation cease to exist.

15. The grant recipient must be fully insured against any risks which may arise from any activities or property which is grant aided, including loss or personal injury to persons undertaking those activities. DCF is not liable for any contingency involving property or activities for which they have provided grant aid in whole or in part.

16. The grant recipient should ensure that services provided by and through the grant are underpinned by equality and diversity principles. Ensuring there is no discrimination on the grounds of characteristics that are protected by the Equality Act 2010: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation.

17. The grant recipient understands that providing false or misleading information in this application or subsequent communications related to this funding programme could lead to funds being withheld or [subsequently] recovered.

18. If an Event of Default occurs, DCF may require you to repay all or part of the Grant. An Event of Default occurs if:

You fail to comply with these Grant Terms & Conditions
You fail to take adequate measures to investigate and resolve any reported Financial Irregularity
You change the nature of your operations to an extent we reasonably consider to be material, including if you (or any substantial part of your operations) merge with or are taken over by another organisation
You have a petition for an administration order or a winding up order brought against you before the end of the funding period
You are involved in illegal activity in your administration of the funded activities
You take any actions which in our reasonable opinion are likely to bring our name/reputation into disrepute
You are otherwise in material breach of these Grant Terms & Conditions

Declaration

I confirm that the information given on the application form is true and I certify that I am authorised by the organisation to accept these Grant Terms and Conditions on their behalf.

I confirm that I have read and understood the Grant Terms and Conditions and if funded, our organisation agrees to accept the Grant Terms and Conditions.

Declaration Approved

Yes

Save my progress and resume later | Resume a previously saved form

Other grant programmes and Contact Information
Data collection and storage information