Communities and Service Support
Advice and Information Services
Commissioning
Grant Funding
Application Form
This form must be completed and returned to us along with all
accompanying information by
5:00pm, Thursday 20th October 2016
Please make sure that you read the guidance notes before completing the application
form.
You should also read the details of the assessment process enclosed with this form. This
will help you understand what we are looking for.
If you have any questions about how to complete this form, or if you would like a copy of
these documents in a different format, please contact us:
Stephanie Jones
Email:
Tel: 01422 393003
[email protected]
These documents, including the application form, are
available in large print.
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Application for Advice and Information Services Grant Funding
Section 1: About your organisation
1a) Organisation name
1b) Organisation address (including postcode)
1c) Details of other organisations involved
1d) Contact name
1e) Contact address (if different to 1b)
1f) Daytime telephone number
1g) Email address
Please tell us about any particular communication of your main contact e.g. uses
textphone, large print or Braille.
1h) Do you have a constitution or similar document?
Yes
No
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You must send us a copy of this document, signed and dated at the time of adoption or
amendment, with your application.
1i) Do you have audited annual accounts or, if this is new organisation, a 12 month
income and expenditure forecast?
Yes
No
You must send us a signed copy of this document with your application.
1j) What does your organisation do?
(i.e. what are its activities, what services does it offer, who uses these services).
1k) Does your organisation meet all of the minimum management standards? (These
are shown in the appendix of the ‘Overview & Guidance’ document.)
Yes
No
If you answered “No”,
explain which ones are
new to you, what you
intend to do about them
and by when.
1l) Do you already receive funding from Calderdale Council for any other part of
your organisation?
Yes
No
If you answered “Yes”,
please give details,
including the name of the
Council officer who deals
with that funding
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Calderdale Council wants to use this money to support voluntary and community
organisations who provide advice and information support services because we believe
that the voluntary and community sector provides a range of benefits, many of which
cannot be matched elsewhere.
1m) Please explain and demonstrate how funding your organisation in particular will
achieve these benefits.

Access to match funding

Value for money services including
those which use the contribution of
volunteers

Reach into excluded and vulnerable
groups of people, whom we often find
hard to reach.

Innovation and creativity
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Section 2: What are you applying for?
The objective of this scheme is to support the holistic information and advice needs of the
vulnerable groups of people identified in the ‘Overview & Guidance’ document.
2a) Which potentially vulnerable group of people does this advice and information
project/service aim to support? (Please tick all that apply)
People with health needs (physical and mental)
People with chaotic lifestyles
People facing language barriers (including refugees and asylum seekers)
2b) What is the aim of
your advice and
information
project/service?
2c) What will your
project/service do and
how is it delivered?
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2d) How do you work
with other
organisations tackling
this issue? Are there
other organisations
working in the same
area as you or with the
same client group?
2e) How will you
provide peer support to
other voluntary and
community
organisations in
Calderdale?
2f) What evidence do
you have to show that
your project is of a
high quality?
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Section 3: Impact
3 How will you measure what your project is doing, and whether it is making a
difference?
Definition & Targets
Year 1
Year 2
Year 2
Outputs
Outcomes
Proposed content of your
end of project impact
report
Section 4: Funding
4a) How much are you applying for from this grants programme?
Inflation will not be added automatically to this grant in future years. If you want to include
an allocation for inflation you must include it in the costs below.
Year 1
Year 2
Year 3
Total
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4b) Are you applying for the
whole cost of this
project/service?
4c) If not, where is the rest
of the funding coming from?
If you are including volunteer
time as match funding, please
show how you have calculated
this.
Yes
Source
No
Amount
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Secured?
(Yes/No)
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4d) Please provide a breakdown of the costs you are applying for
Cost
Year 1
Year 2
Year 3
Total
If you are including an element of core costs, please show how these have been calculated.
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4e) If we awarded your
organisation this
funding, what would
happen to this
project/service when
our funding ended?
Section 5: Supporting information
5a) Have you included the following supporting documents?
Signed and
dated constitution
or similar document
Signed most recent set of
accounts (or 12 month financial
forecast if your organisation has
been in operation less than 12
months)
Your application will be considered ineligible if you have not submitted these documents with
this form.
5b) Is there any other information, which you think we should take into account when
considering your application?
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Data protection
As part of the decision-making process, information from this application and details of its
assessment will be included in a report to the evaluating panel members and the Council
Member who is portfolio holder for Neighbourhoods and Communities. This will also be
available to the public.
Copies of this application form and accompanying information may be available to Council
members for inspection.
We may give copies of all or some of this information to other sections of the Council and to
other partner organisations when assessing applications and monitoring grants.
If awarded, we will use the information you give us on this application form during the life of
the grant for administration and monitoring and the amount awarded to your organisation will
be published.
Your contact details will be added to our database to receive information about future funding
and other voluntary and community sector initiatives.
If you do not want to receive any further information, please tick this box
Freedom of Information Act
The Freedom of Information Act 2000 gives members of the public the right to request any
information that we hold. This includes information received from third parties, such as,
although not limited to; grant applicants, grant holders, contractors and people making a
complaint.
If information is requested under the Freedom of Information Act we will release it, subject to
exemptions; although we may consult with you first. If you think that information you are
providing may be exempt from release if requested, you should let us know when you apply.
We will take your signatures on this form as confirmation that you understand our obligations
under the Data Protection Act 1998 and the Freedom of Information Act 2000 and that you
accept that we will not be liable for any loss or damage to you pursuant to our fulfilment of
our obligations under the relevant law.
Signed
Name
Position in the organisation
Date
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