NNS Small Grant Application

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Page 1

Admin Section ( WILL BE HIDDEN - DO NOT EDIT )
Programme Description
 
About The Programme
 

Our Terms and Conditions
 
This Programme Is Not Open Yet
This programme is not currently open to applications. 
This Programme Is Closed To Applications
This programme is currently closed and not accepting applications.

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MAIN CONTACT DETAILS

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ORGANISATION CONTACT DETAILS
As it appears on any governing documents.
The telephone number should be one at which the organisation is easily contactable, especially during office hours.

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ORGANISATION DETAILS

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ORGANISATION DETAILS
Unrestricted Reserves: Money shown in your accounts at the end of the financial year that can be spent on whatever the management committee sees fit. The Charity Commission recommends organisations have 3-6 months unrestricted reserves.

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BANK DETAILS

Bank Details

The Banks Address

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PROJECT, ACTIVITY OR SERVICE DETAILS
If you do not have a name for the project, activity or service, that it OK. This field is not required.
If your project, activity or service is ongoing, you should enter the start and end dates of the funding period.
Tell us who you are, what you do, who you support and why your work matters.
Tell us about the specific project, service or activity for which you are seeking funding. What do you want to do and how will you do it?
Provide relevant local findings from official statistics and reports, results of your own surveys, consultations, quotes, etc.
How do you know your project is needed in your community? Explain how citizens will participate in running this activity. If you haven't engaged with local citizens to design your project, please explain why.
If your project takes place in more than one ward, please select which ward the majority of your beneficiaries will come from.

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PROJECT, ACTIVITY OR SERVICE DETAILS
If multiple outcomes apply, please select the main one.
Public Health Impact Measures

Some projects, dependent on amount applied for and type of project, are required to use a Public Health Impact Measure as a condition of their Neighbourhood Network Scheme grant funding. Please check with your NNS team whether this applies to you. They will provide you with the guidance needed.
Who will benefit from this project? Please select all that apply.
How many Adults aged 50+ will your project reach?
How many Younger adults with additional needs will your project reach?
How many Carers will your project reach?

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HOW WILL YOU MEASURE SUCCESS?
For grants above £999

Using the fields below, please let us know how you will measure the success of any funded activities.

If you are applying for more than £999, please let us know how you intended to measure success for at least one activity. You can include the measures of success for up to 5 activities funded my this grant.

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PROJECT TIMELINE
For grants above £4,999

If you are applying for more than £4,999, you are required to submit a project timeline as part of your application.

Using the fields below, please provide a short description of each phase of your project, including which activities will be carried out within the time period.

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RISK ASSESSMENT
For grants above £9,999

If you are applying for more than £9,999, you are required to submit a risk register as part of your application.

Using the fields below, please let us know about any potential risks you have identified that could have an effect on the delivery of your project. What impact will the risk have? How do you plan to respond to the risk, should it occur? You should include up to 5 potential risks for this section of your application.
Low Medium High
Low Medium High
Low Medium High
Low Medium High
Low Medium High

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TARGET ISSUE

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TARGET BENEFICIARIES
Please select the primary beneficiary group for this grant
Please select up to two other beneficiary groups that will benefit from your project.
Please select no more then 3 Secondary Beneficiaries

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TARGET AGE GROUP
Please select the primary age group that will benefit from this project
If applicable, please select a maximum of three other applicable age groups that will benefit from this project
Please select no more then 3 Secondary Age Groups

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TARGET ETHNIC MINORITY GROUP
Please select the primary ethnic group that will benefit from this project
If applicable, please select a maximum of three other applicable ethnic groups that will benefit from this project
Please select no more then 3 Secondary Ethnicities

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BUDGET
For any values/amounts provided below, please include VAT.
Staff Budget Breakdown
E.g. How many hours, how many sessions, cost per hour and duration of delivery, salary per annum, etc.
To the nearest whole number. eg. for £999.99, please enter 1000
To the nearest whole number. eg. for £999.99, please enter 1000
Volunteer Budget Breakdown
E.g. Travel costs.
To the nearest whole number. eg. for £999.99, please enter 1000
To the nearest whole number. eg. for £999.99, please enter 1000
Operational Budget Breakdown
E.g. Room hire cost per hour, how many hours, etc.
To the nearest whole number. eg. for £999.99, please enter 1000
To the nearest whole number. eg. for £999.99, please enter 1000
Publicity Budget Breakdown
E.g. Leaflets, advertising costs, etc.
To the nearest whole number. eg. for £999.99, please enter 1000
To the nearest whole number. eg. for £999.99, please enter 1000
Office Budget Breakdown
To the nearest whole number. eg. for £999.99, please enter 1000
To the nearest whole number. eg. for £999.99, please enter 1000
Capital Budget Breakdown
To the nearest whole number. eg. for £999.99, please enter 1000
To the nearest whole number. eg. for £999.99, please enter 1000
Other Budget Breakdown
To the nearest whole number. eg. for £999.99, please enter 1000
To the nearest whole number. eg. for £999.99, please enter 1000

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BUDGET
The below amounts are based on what you have entered on the previous page.
Please let us know which NNS you have previously applied to/received funding from. What was the funding for, how much did you receive?

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ADDITIONAL DOCUMENTS
Please ensure each file is less then 5mb in size, or you may get an error when you try to submit. If this is something you are unable to do, please speak to a member of our team.

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EQUALITY MONITORING
The West Midlands and Warwickshire is a vibrant and diverse region.  It is home to so many communities of different heritage backgrounds, cultures, and faiths. It has rural and urban areas, includes one of the youngest cities in Europe, and around a fifth of people are living with a physical or mental condition that affects their daily lives.

To ensure our decision process is as equitable as possible, we would like you to answer a few questions about the makeup of your organisation's leadership team. This will help us to identify any potential gaps and make sure our reach reflects the diversity of the West Midlands and Warwickshire. If you don’t already know the makeup of your leadership team, finding out might be a useful and interesting exercise for your organisation.

This information will not be used to assess your application.

For our full privacy policy please visit: https://www.heartofenglandcf.org/privacy-policy/ 

For each question below, please specify the number of senior employees, directors and/or trustees that fit the relevant category. If none of your team members fit a certain category, please enter '0' for that question.
Ethnicity
Asian or Asian British
Black, Black British, Caribbean or African
Mixed or multiple ethnic group
White
Other ethnic group
Gender
Sexual Orientation
Age
Disability

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DECLARATION
Public Health Impact Measure Checklist:
It is a requirement of the fund that applicants have discussed their proposal prior to submitting an application and for the applicant to be involved in NNS work locally.
By ticking the box below:
  • You accept that if you leave the organisation or can no longer fulfill your responsibilities, or someone else takes over responsibility for the grant on behalf of the organisation, you must inform us immediately. · You accept the terms and conditions of the grant as they are set out in this application form and the guidance notes.

  • You certify that the information contained in this application is correct and that you are authorised by the organisation to accept these conditions on their behalf.

  • You will only spend the grant for the purposes outlined in this application unless you have received written confirmation, from the Foundation, that you can make a variation of spend.

  • You accept that the Foundation will, under no circumstances, be liable for any damage, injury or loss of any kind whatsoever to any property or persons occurring as a result of activities undertaken with this grant.

  • You will ensure that all necessary permits and licenses have been obtained for any event or project funded by the grant and that the event or project complies with all relevant regulations.

  • You acknowledge that you cannot sell or dispose of any equipment or other assets funded or part funded by the Foundation without first receiving written permission.  If any equipment or assets are sold within their working life without such undertaking, the Foundation can ask for a percentage of the original grant to be re-paid.

  • You confirm that the grant will not be used for the provision of services to asylum seekers when those services are inconsistent with immigration laws or Home Office policy. You understand this includes, but is not limited to: the promotion of work based training to asylum seekers; the provision of employment to asylum seekers unless they are otherwise permitted to take employment; and the provision of services or activities, to asylum seekers, which are intended to assist with the integration of refugees.

  • You accept that you must keep all financial records and accounts including receipts for items bought with the grant for at least 6 years. These must be made available to the Foundation if requested.

  • You give permission for the Foundation to record the information in this form electronically and to contact your organisation by phone, mail or email with regards to this application.

  • You accept that Heart of England Community Foundation may follow up on successful applicants and potentially feature them in publicity activities.

  • You accept that if your application is successful, that you are willing to take part in, where appropriate, in any publicity activities.

  • You agree to Heart of England Community Foundation collecting, processing, storing and sharing information provided on this application, as part of the assessment and monitoring process in line with their Privacy Policy. This includes the sharing of information on grant applicants with grant panel members, donors and approved suppliers e.g., marketing agency. We will also publish a full list of all successful grant recipients externally. This includes group/organisation’s name, amounts awarded, location and purpose of grant.Signing this form electronically
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Heart of England Community Foundation Contact Information