Herefordshire Together Grant Application Form

Herefordshire Together Grant Application Form

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Herefordshire Council 2

You are about to apply for a grant from Herefordshire Community Foundation.

Aims of the Herefordshire Together fund

Create lasting and meaningful connections for people to improve their emotional wellbeing and sense of community belonging
Strengthen the reach to families in need

Project costs

Herefordshire Together has two thresholds for funding:

Grants up to £1,000
Grants between £1,000 and £20,000

Please read the following text before beginning your application.

The application can be saved at any point for you to resume at a later date. It is advisable to check you can save your application before completing it, particularly if you are using a phone. You can do this by scrolling to the bottom and clicking on the save draft. Click on the link again to continue completing the form. Once you have saved for the form it will upload to our system.

If you need support, please contact our Grants Officer via email to office@herefordshirecf.org or telephone 01432 272550.

Further information regarding the application process can be found by visiting our website www.herefordshirecf.org and clicking on the Apply tab.

Click here to view our terms and conditions

Section 1 - Organisation

Organisation Name and Address Details

Name of organisation

Provide the name of your organisation as it appears on any governing documents. If you are known by another name, please tell us as well.

Address of your organisation

Street

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.

Town/city

County

Postcode

Website

Telephone

General/Office Email

Main Contact Details

These are the details that will be used for correspondence purposes.

Title

Forename/s

Surname

Job Title

Work/Office Phone

Home Phone

Mobile Phone

Email

Use Organisations Address For Correspondence

Yes

Start Date

Organisation Start Date - Month

Organisation Start Date - Year

What Type of Organisation Are You?

A Registered Charity

Yes

If yes, please enter Charity Number

Limited Company

Yes

Company Number

Unincorporated Club or Association

Yes

Community Interest Company

Yes

CIC Number

Other

Yes

If Other, Please Specify

Are you part of a larger regional or national organisation

Yes

What was your total income over the last accounting year?

Staffing and Volunteers

Number of Full Time Staff/Workers

Number of Part Time Staff/Workers

Management Committee Members

Number of Volunteers (Excluding Management Committee)

Please describe the overall aims and objectives of your organisation and the activities or services your organisation provides

To help us understand the difference you make, please tell us how you have helped an individual in the past and the change your organisation has made to their life

Please explain why the people in your community need your organisaiton?

Section 2 - About your grant application

Project Details

Project Name

Project/Funding Start Date

Project/Funding End Date

Which area (estate, village, town, borough) do most of the people who benefit come from?

Please provide a postcode (or postcodes) which represents the geographic area that will benefit

What needs and disadvantages will your project address and what opportunities will you create?

How will you spend this grant to address the need in your area?

Please provide evidence of design of your project demonstrating that you have worked with yoru community to ensure that the project meets their needs

Please explain how the project will have a lasting impact and provide a legacy

Please describe any collaborations of alignment with existing initiatives

Please explain how your project meets the county health and wellbeing strategy priorities: 1. Best start in life (0-5 year olds); 2. Good mental wellbeing throughout life

Section 3 - Impact

Impact

Does your project meet fund Priority 1: How does your project create lasting meaningful connections for people to improve emotional wellbeing and sense of community? Please hold down control to select more than one impact option

Does your project meet fund Priority 2: How does your project strengthen the reach to families in need? Please hold down control to select more than one impact option

Beneficiaries

How many people will benefit from this funding?

Primary Beneficiary

Other Beneficiaries

Ethnicity

Primary Ethnic Group

Other Ethnic Groups

Issues

Primary Issue

Other Issues

Age Groups

Primary Age Group

Other Age Groups

Section 4 - Project Budget and Consent

Project Budget and Consent

Total project cost

Amount raised so far

How much money are you applying to us for?

Staff Costs

Staff Costs - Total Amount

Staff Costs - Breakdown

Staff Costs - Requested Amount

Volunteer Costs

Volunteer Costs - Total Amount

Volunteer Costs - Breakdown

Volunteer costs - Requested Cost

Operational/Activity Costs

Operational/Activity Costs - Total Amount

Operational/Activity Costs - Breakdown

Operational/Activity Costs - Requested Cost

Office, Overhead, Premises Costs

Office, Overhead, Premises Costs - Total Amount

Office, Overhead, Premises Costs - Breakdown

Office, Overhead, Premises Costs - Requested Cost

Capital Costs

Capital Costs - Total Amount

Capital Costs - Breakdown

Capital Costs - Requested Cost

Publicity Costs

Publicity Costs - Total Amount

Publicity Costs - Breakdown

Publicity Costs - Requested Cost

Other Costs

Other Costs - Total Amount

Other Costs - Breakdown

Other Costs - Requested Cost

Supporting Documents

Upload supporting documents - Governing Document

Upload supporting documents - Bank Statement

Upload supporting documents - Statutory Annual Accounts

Upload supporting documents - Equal Opportunities Policy

Upload supporting documents - Child Protection Policy

Upload supporting documents - Vulnerable Adult Policy

Upload supporting documents - Quotes

Upload supporting documents - Other

Documents to Follow in Post

Yes

Declaration

The Community Foundation would like to follow up on successful applicants and possibly feature them in publicity activities. Please tick this box to confirm that, if your application is successful, you are willing to take part in, where appropriate, an publicity activities.

Declaration Approved

Yes

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