A charity endowed by the Will of Richard Cloudesley on 13th January 1517 serving churches and health and welfare needs in the London Borough of Islington.
Richard Cloudesley Trustee Limited Co. Reg. No. 7425897 Charity Commission Reg. No. 205959
Office 1.1, Resource for London, 356 Holloway Road, London, N7 6PA
Tel: 0207 697 4094 Email: [email protected]
www.cloudesley.org.uk
APPLICATION FOR A CHURCH GRANT – SPRING 2017 ROUND
Closing date: 5.00pm Monday 10th April 2017
Late applications may not be considered
Please read the Spring 2017 version of the Guidance Notes and Frequently Asked Questions before
completing the application.
Please email your application in Word (and any necessary attachments that you have electronic
copies of in whatever format you have) to [email protected] and then post the signed copy
of the ‘Declaration and Checklist’ page only with any accounts, estimates etc for which you only have
hard copies. Please see notes at the end of this form.
Section 1: Your Church
1.1 Name of Church:
1.2 Deanery ID:
1.3 Name of Contact Person for this application:
Position/role in the Church:
1.4 Address for correspondence:
Post Code:
Telephone No:
1.5 Email:
1.6 What is the total number on the electoral roll for the church in this application?
Electoral Roll number:
At date:
NB – if part of a team/group, please answer for this church only
1
Application Form Spring 2017
1.7 What is the average number attending your main Sunday service over the past three months:
Period:
Average number - adults:
Average number – children:
Please state whether these numbers are increasing, decreasing or reasonably static
1.8 Staff members and volunteers:
Number of full time staff:
Number of part time staff:
Number of volunteers:
Please provide a summary of key staff and volunteer roles
1.9 How many people use the Church premises?
Please complete the table below, listing the groups which meet in your premises (Church and
Church Hall etc) with an estimate of attendance
Church or Church
Hall?
Group Name
Frequency
Please state regularity
(e.g., weekly, monthly)
and how often (e.g., 52
weeks per year)
For example: Church
Hall
Brownies
Weekly for 39 weeks per
year
Number of
adults
Number of
children
Average per
session
Average per
session
3
15
1.10 On what days and hours is the Church open to visitors?
Days:
Hours:
2
Application Form Spring 2017
Section 2: Your Project/Works
2.1 Brief summary of purpose for which funds are requested:
This should describe what the money is to be used for (50 words maximum)
Reasons and benefits should be set out elsewhere.
2.2 Total Project/Works Cost: £
Amount Requested from Cloudesley towards this: £
2.3 Funding Stream applied to:
For details of each of the Charity’s funding streams, please see the Guidance Notes. Please tick one of
the following to indicate which funding stream you are applying to.

Capital and major developments

Enabling major developments

Substantial repairs, refurbishment and equipment

Capacity building
2.4 Details of the work to be funded
Describe the need for the work/project and how the need was assessed.
What will be provided and who will do the work?
3
Application Form Spring 2017
What do you aim to achieve? How will that advance the mission of the Church to the people of
Islington?
Why are you applying for funding now for this work/project?
2.5 Project/works timescales relating to this funding request
Expected start date for the project/works (month/year):
Expected finish date for project/works (month/year):
2.6 Planning, faculty and other consents
If any planning, faculty or other consents are required for the project to proceed, please provide
details and indicate what stage have the applications reached.
2.7 Consultation
If relevant, please give details of any consultation that has been/will be carried out in relation to this
project/work. Please include a summary of any concerns/issues raised and how these have been/will
be addressed.
4
Application Form Spring 2017
2.8 Impact and effectiveness
How will you review and measure the impact and effectiveness of the work/project?
2.9 Beneficiaries
How many people are expected to benefit from this grant over 12 months?
Who will benefit from this grant?
Please provide a breakdown of the anticipated ages and gender of beneficiaries
5
Application Form Spring 2017
Section 3: Finances
3.1 Project / works budget
Please ensure you:
 Complete every section of the table below
 List each item or activity included in the whole of the project/works (not just those elements for which
you are seeking funding from Cloudesley)
 Indicate VAT where applicable
If you have any questions about this table, please contact the Charity’s office.
EXPENDITURE:
A. Project / works
Please list each item of the project / works separately
TOTAL PROJECT/WORKS COST:
B. Cost
excluding VAT
(£)
C. VAT (£)
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
£
(Fig. 1)
Amount raised
(£)
Is this funding towards a specific
item from the expenditure list
above, or a general contribution
towards the total project cost?
If applicable
D. Total cost
(£)
Sum of columns
B+C
INCOME – CONFIRMED:
(Income already raised)
Funding source
Please state specific items where applicable
Church fundraising
£
Church reserves
£
Church – other (please state)
£
Loan – London Diocesan Fund
£
6
Application Form Spring 2017
Loan – other (please state)
£
Other funder (please state)
£
Other funder (please state)
£
TOTAL INCOME ALREADY RAISED:
£
£
(Fig. 2)
Previously awarded from Cloudesley this project/works:
Amount(s) previously awarded by Cloudesley £
Only enter previous awards related to this project/works
(Fig. 3)
Granted towards (please state specific items):
INCOME – POTENTIAL:
(Income applied for but not yet confirmed)
Amount requested now from Cloudesley towards this project/works:
Requested towards (please state specific
Amount requested in this application
£
items):
(Spring 2017)
(Fig. 4)
Other funders currently considering your proposal:
Funder / source
Decision date
Amount
requested
Please state the name of each funding
Please state the
source
expected decision date (£)
for your application
Is this funding towards a specific
item from the expenditure list
above, or a general contribution
towards the total project cost?
Please state specific items where applicable
£
£
£
£
TOTAL OTHER FUNDING
APPLIED FOR:
VAT recovery:
Listed Places of Worship Scheme
£
(Fig. 5)
£
(Fig. 6)
7
Requested towards (please state specific
items):
Application Form Spring 2017
BUDGET SUMMARY:
Please insert the expenditure and income figures from your breakdowns above
EXPENDITURE:
Total project / works cost (Fig. 1)
£
(Fig. 1)
INCOME - confirmed:
Income already raised (Fig. 2)
Previously awarded by Cloudesley (Fig. 3)
Total confirmed income:
£
£
£
INCOME - potential:
Requested from Cloudesley Spring 2017 (Fig. 4)
Other funding applied for (Fig. 5)
VAT recovery (Fig. 6)
Total potential income:
£
£
£
£
TOTAL INCOME (confirmed + potential):
£
(Fig. 7)
SHORTFALL OR SURPLUS (Fig. 7 – Fig. 1):
£
3.2 Reserves
What level of unrestricted reserves (both general and designated funds) do you have? Please
indicate how much of this is held as fixed assets.
How much of your reserves can be applied to the project/works for which you are requesting this
grant? (Listed under ‘Income already raised’ above).
If you have designated funds, please explain the purpose of each designation.
3.3 Shortfall or surplus
Taking into account the information in the Budget Summary table above, please explain how
any shortfall or surplus will be managed.
8
Application Form Spring 2017
Section 4: Declaration and Checklist
Declaration to be signed on behalf of the Church
Name of Church:

To the best of my knowledge, all the information that has been provided in this application
form is correct

The project/works for which funding is sought has been considered and is supported by the
PCC
Sharing information:
I understand that the information provided as part of this application may be shared by the Charity
with other funders and relevant parties. I also understand that the Charity may approach other
funders and other relevant parties to discuss this application as part of the assessment process.
Signature of Applicant/Contact on page 1
Counter-Signature by Vicar or Churchwarden
Signed:
Signed:
Print name:
Print name:
Position:
Position:
 Vicar  Churchwarden
Please note: in the case of a team parish the counter-signatory
should be the same signatory as that of the summary provided
which indicates the priority of all applications for the parish
(see “Guidance Notes – Other Information”)
Date:
Date:
Checklist – please check the following points have been completed:







Answered all the questions in the spaces provided
Annexed your most recent signed, audited or independently examined accounts (if not
previously supplied)
Annexed any estimates or quotes, plans and permissions (as requested in the Guidance Notes)
Annexed evidence which shows that the planned works/project and this funding application
have been discussed and agreed by the PCC
Completed the Declaration on behalf of the applicant Church with two signatures and the
Checklist
Retained a copy of the application form
For a team: provided a summary covering the priorities for the parish (see Guidance Notes –
Other Information)
9
Application Form Spring 2017
The full application should be emailed as a Word document, together with any necessary attachments, to
[email protected] by 5pm on Monday 10th April 2017
A hard copy of the above declaration must then be printed, signed and posted,
(together with any supporting documents for which you only have hard copies available)
to reach us by 5pm on Thursday 13th April 2017:
Cloudesley
Office 1.1, Resource for London
356 Holloway Road, London, N7 6PA
Revised January 2017
10
Application Form Spring 2017