Dublin City Sport & Wellbeing Partnership
Sport for Young People - Small Grants Scheme
Grant Application Form 2016
NAME OF CLUB: ___________________________________________________
ADDRESS OF CLUB: (Exact club location)
_____________________________________________________________________
_____________________________________________________________________
TYPE OF SPORTING ACTIVITY: __________________________________________
NATIONAL GOVERNING BODY TO WHICH CLUB IS AFFILIATED:
_____________________________________________________________________
AGE GROUP CATERED FOR: __________________________________________
NUMBER OF PARTICIPANTS: (10-21 yrs old) ______ Male
Female
NAME AND HOME ADDRESS OF PERSON TO WHOM
ALL CORRESPONDENCE TO BE SENT: ___________________________________
___________________________________
___________________________________
___________________________________
POSITION IN CLUB: ___________________________________________________
TELEPHONE NO: _____________________________________________________
EMAIL ADDRESS: _____________________________________________________
AMOUNT OF GRANT SOUGHT: Please note Grant allocations will be between €300€1000, clubs who can identify a special project/programme that aims to significantly
increase the number of young people participating in sport will be favoured.
PURPOSE FOR WHICH GRANT, IF APPROVED, WILL BE USED:
(Please attach additional information if required)
_______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
PLEASE LIST ITEMS AND ESTIMATED COST FOR WHICH GRANT ASSISTANCE IS
SOUGHT, INCLUDING BREAKDOWN OF ALL COSTS:
ITEMS
ESTIMATED COST
ANY OTHER COMMENTS YOU WISH TO MAKE IN SUPPORT OF YOUR APPLICATION:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
BANK DETAILS:
BANK: __________________________________________________________________
ADDRESS: _______________________________________________________________
BANK ACCOUNT NUMBER: _________________________________________________
BANK SORT CODE: ________________________________________________________
NAME IN WHICH ACCOUNT IS HELD: ________________________________________
BIC NUMBER_____________________________________________________________
IBAN____________________________________________________________________
*BANK ACCOUNTS MUST BE IN THE NAME OF THE CLUB/ORGANISATION. GRANTS
WILL NOT BE PAID INTO AN INDIVIDUAL PERSON'S ACCOUNT. PLEASE SUPPLY
COPY OF MOST RECENT CLUB BANK ACCOUNT STATEMENT.
Please fill in the Electronic Funds Transfer Form (attached) and return it to the same
address as the Grant Application (This form should only be completed if your club
has NOT received funding from Dublin City Council in the past OR If your bank details
have changed).
CLUB COMMITTEE DETAILS: (name & contact number)
CHAIRPERSON: ________________________________________________________
SECRETARY: __________________________________________________________
TREASURER: __________________________________________________________
CHILDREN’S OFFICER: __________________________________________________
INSURANCE DETAILS:
INSURANCE COMPANY (NOT BROKER): __________________________________
POLICY NUMBER: _____________________________________________________
AMOUNT INSURED: ____________________________________________________
PROPERTY: __________________________________________________________
PUBLIC LIABILITY: _____________________________________________________
TRAINING
HAVE COACHES OR VOLUNTEERS RECEIVED TRAINING IN:
CODE OF ETHICS/CHILD PROTECTION IN SPORT
Number of Coaches:
SPORTS FOUNDATION/COACH LEVEL
Number of Coaches:
FIRST AID
Number of Coaches:
Please note that as a club/sporting organisation you must practice good governance within
your club and ALL coaches/volunteers must be GARDA VETTED, if for any reason you have
coaches/volunteers who are not Garda vetted please contact your relevant National
Governing Body for assistance or Dublin City Sport & Wellbeing Partnership for advice.
Have all your coaches/volunteers been Garda vetted? Please tick
YES
NO
If Dublin City Sports Network were to host a Club development seminar in 2016 what
top 3 key issues/themes would you like to see discussed at this seminar?
1.
2.
3.
SIGNATORIES
*This application must be signed by two Committee members of your
Club/Organisation
Statement: " To the best of my knowledge Statement: "To the best of my knowledge
the information provided on this form is
the information provided on this form is
true and accurate"
true and accurate"
Signed:
Signed:
Position:
Position:
Date:
Date:
Completed application form should be returned to:
Dublin City Sport & Wellbeing Partnership
4th Floor, No. 3 Palace Street
Dublin 2
For queries please contact Emmet Flinter, Administrator, tel: 2227852
Email: [email protected]
Closing date: - Friday 29th April 2016 @ 4pm
Please note that in the event of over-subscription, grant applications will be shortlisted.
For Official Use Only
DCC Staff to complete this section prior to sending form to Supplier
Staff Name:
__________________ Section:
______________
Phone No:
__________________ Department:
______________
______________
Bank Details for the purpose of Supplier Payment
Via Electronic Funds Transfer
DETAILS TO BE COMPLETED BY SUPPLIER
Supplier Name
Contact Address
Phone Number
E-mail Address
PPS / VAT Number
Name of Bank
Address of Bank
Bank Sort Code
Bank Account Number
BIC
IBAN
Signature form will not be
accepted without a signature
Block Capitals
Position In Company
PLEASE RETURN THIS FORM TO:
Dublin City Sport & Wellbeing Partnership
4th Floor, No. 3 Palace Street,
Dublin 2
Dublin City Council Office use only – Finance Department
Vendor No:
Date:
Input By:
Date:
Checked By:
What is BIC?
The BIC or Bank Identifier Code (also known as the SWIFT address) is a unique address
which in payment messages identifies precisely the bank involved in financial transactions.
When used in conjunction with the IBAN it identifies the bank at which the account of the
beneficiary is held.
What is IBAN?
IBAN stands for International Bank Account Number,
It was created as a viable and practical international bank account identifier, used
internationally to uniquely identify the account of a customer at a financial institution, to
assist error-free cross-border payments and to improve the potential for straight-through
payment processing.
EU banks are legally required to provide their customers with an IBAN for each bank
account.
Where can I find the BIC and IBAN for my accounts?
Your BIC and IBAN are printed on your bank statement. You can also request them directly
from your bank.
Does the IBAN replace my existing account number?
No, your IBAN does not replace your existing account number. It is important to remember
that IBAN is not a new account number but simply a new format for an existing account
number which is recognised internationally.
What does an Irish IBAN look like?
IE33AIBK93123487654321
IE
Country Code for the Republic of Ireland
33
two check digit numbers
AIBK
the first four digits of the BIC (bank identifier code)
931234
National Sort Code
87654321
Account number
An Irish IBAN is always 22 digits long