DEPARTMENT OF JUSTICE, EQUALITY
AND LAW REFORM
APPLICATION FORM
FOR ORGANISATIONS APPLYING FOR
FUNDING UNDER THE
ENHANCING DISABILITY SERVICES
PROGRAMME
FINAL ROUND
APPLICANTS ARE REQUIRED TO HAVE FAMILIARISED
THEMSELVES WITH THE GUIDELINES PERTAINING TO
THE
ENHANCING DISABILITY SERVICES PROGRAMME
PRIOR TO COMPLETING THIS APPLICATION FORM
APPLICATION FORM FOR FUNDING UNDER
THE ENHANCING DISABILITY SERVICES PROGRAMME
1. Introduction
2. Application Form
ƒ Part 1: Details of Applicant
ƒ Part 2: Project Details
ƒ Part 3: Timescale and Financial Information
3. Checklist
4. Declaration
5. Appendices: (1) proposed detailed time scale for the project
(2) detailed project financial plan/project budget
1. Introduction
All applicants are requested to read the introductory comments below and have read
and agree to be bound by the guidelines, terms and conditions pertaining to the
Enhancing Disability Services Programme (EDS).
An electronic version of this application form and the corresponding guidelines/terms
and conditions are available on www.justice.ie or www.pobal.ie
Alternatively, an application form can be obtained by telephoning Pobal on 01 4484892. Application forms in an alternative format are available upon request.
If a particular question is not applicable to your application please enter N/A.
If it is the intention of an organisation to submit two (2) applications under the
Enhancing Disability Services Programme these must be submitted on two separate
application forms, as they will be treated as such. In these cases two application
forms and financial budgets etc. must be completed with separate supporting
documentation. These must be submitted in separate envelopes.
Applications should, where possible, be submitted in typescript and will not be
considered if they are received after the specific deadline, are incomplete or are
submitted electronically/by fax.
Applications must be directly related to the criteria outlined in the EDS Programme
Guidelines.
All applications will be acknowledged on receipt and applicants will be notified of the
decision regarding their application as soon as possible. Unsuccessful applicants will
be advised of the reason(s) why they have not been successful.
Successful projects will enter into a contract with Pobal, operating on behalf of the
Department of Justice, Equality and Law Reform, for the period specified in the
contract.
If you require assistance on completing any aspect of this application form please do
not hesitate to contact Pobal on 01 – 4484892
2. Application Form (Block Capitals & Black Ink)
Part 1. Details of Applicant
Q1. Name and contact details of the applicant organisation. For this part of the
application only one applicant name is required. The different partner organisations
must appoint one lead organisation for co-ordination and liaison with Pobal, working
on behalf of the Department of Justice, Equality and Law Reform.
NAME OF LEAD APPLICANT ORGANISATION:_____________________________________
_____________________________________________________________________
POSTAL ADDRESS: ________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
TELEPHONE No.: _________________________
FAX No.: _______________________________
E-MAIL ADDRESS: ______________________________________________________
WEBSITE ADDRESS: ____________________________________________________
Q2. Legal Status of the Lead Applicant, e.g. company limited by guarantee,
cooperative, etc.
DATE OF ESTABLISHMENT:_______________________________
TAX CLEARANCE CERTIFICATE NUMBER:___________________(please attach copy)
ELIGIBLE CHARITY CERT. No.:______________________________(please attach copy)
VALID UNTIL:____________________
IF YOU ARE UNABLE TO SUPPLY THE ABOVE PLEASE STATE THE REASON FOR THIS:
Q3. Has the Lead Applicant a Constitution or Articles & Memorandum of
association? YES 
NO 
If yes please attach copy.
If no please give details of the governance arrangements of your organisation:
Q4. Partner Organisations/Additional Applicants:
Please state the number of partner organisations/additional applicants involved in the
proposed project?
_________________________________________________________________________________ 
IN QUESTIONS 4.1 TO 4.3 (OVERLEAF) PLEASE PROVIDE DETAILS OF EACH OF THE
PARTNER ORGANISATIONS. THIS PAGE SHOULD BE COPIED AS REQUIRED TO PROVIDE
THE DETAILS OF EACH ADDITIONAL APPLICANT ORGANISATION.
PLEASE NOTE: ALL PARTNER ORGANISATIONS MUST OUTLINE THEIR ROLE IN
THE PROPOSED PROJECT AND DEMONSTRATE CONCRETE EVIDENCE OF THE
SUBSTANCE OF THEIR INVOLVEMENT, FROM THE PERSPECTIVE OF FINANCIAL
INPUT AND OTHER COMMITMENTS. PARTNER ORGANISATIONS SHOULD PROVIDE
THIS EVIDENCE IN WRITING ON THEIR ORGANISATIONAL HEADED PAPER.
Q4.1. NAME OF ADDITIONAL APPLICANT ORGANISATION:
_____________________________________________________________________
POSTAL ADDRESS: ________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
TELEPHONE No.: _________________________ FAX No.: _________________________________
E-MAIL ADDRESS: ______________________________________________________
WEBSITE ADDRESS: ____________________________________________________
Q4.2. Legal Status of Additional Applicant, e.g. company limited by guarantee,
cooperative, etc.
DATE OF ESTABLISHMENT:_______________________________
TAX CLEARANCE CERTIFICATE NUMBER:__________________
ELIGIBLE CHARITY CERT. No.:_____________________________
VALID UNTIL:____________________
IF YOU ARE UNABLE TO SUPPLY THE ABOVE PLEASE STATE THE REASON FOR THIS:
Q4.3. Please outline the proposed role of each partner organisation in the management
and delivery of the project:
Q5. If a Management / Steering Committee is proposed to guide the project please list
the members:
NAME OF COMMITTEE MEMBER:
ORGANISATION TO WHICH
COMMITEEE MEMBER BELONGS:
Q5.1. Please outline the proposed frequency of Management/Steering Committee
meetings?
_____________________________________________________________________
_____________________________________________________________________
Q6. Legal Representative: One person must be authorised to legally represent the lead
applicant organisation and be the signatory on the grant agreement between Pobal,
operating on behalf of the Department of Justice, Equality and Law Reform, and your
organisation, e.g. chairperson of the organisation, director, company secretary etc.:
NAME:___________________________________ EMAIL: _________________________________
POSTAL ADDRESS:_________________________________________________________________
___________________________________________________________________________________
TELEPHONE No.:____________________
FAX No.:_____________________________________
ROLE OF THE LEGAL REPRESENTATIVE WITHIN THE ORGANISATION:_________________
___________________________________________________________________________________
PLEASE ADVISE IF THIS PERSON HAS ANY SPECIFIC COMMUNICATION REQUIREMENTS:
___________________________________________________________________________________
Q7. Project leader. One person must be appointed from the lead organisation to be
responsible for co-ordination and liaison with Pobal operating on behalf of the
Department of Justice, Equality and Law Reform.
NAME:_________________________________ EMAIL:___________________________________
POSTAL ADDRESS:_________________________________________________________________
___________________________________________________________________________________
TELEPHONE No.:______________________________ FAX No.:____________________________
ROLE OF THE PROJECT LEADER WITHIN THE ORGANISATION:________________________
___________________________________________________________________________________
PLEASE ADVISE IF THIS PERSON HAS ANY SPECIFIC COMMUNICATION REQUIREMENTS:
___________________________________________________________________________________
Q8. Person responsible for financial matters (concerning this project proposal).
Projects must appoint a financial representative for co-ordination and liaison with
Pobal operating on behalf of the Department of Justice, Equality and Law Reform:
NAME:_________________________________ EMAIL: ___________________________________
POSTAL ADDRESS:_________________________________________________________________
___________________________________________________________________________________
TELEPHONE No.:______________________________ FAX No.:_____________________________
ROLE OF FINANCIAL CO-ORDINATOR WITHIN THE ORGANISATION:_______________
___________________________________________________________________________________
PLEASE ADVISE IF THIS PERSON HAS ANY SPECIFIC COMMUNICATION REQUIREMENTS:
___________________________________________________________________________________
Q9. Please state the lead organisation’s mission statement or if available the collective
mission statement or vision of the group of applicants (copies of such documents may
be attached):
Q10. Describe briefly the lead organisations aims, objectives and present activities:
Q11. How many full-time/ part-time staff are there in the lead organisation:
full time:__________________
part time:__________________
Q12. Please provide details of the organisation’s sources of income:
Q13. What is the most recent year for which audited accounts are available for the
lead organisation? ___________________
(please attach a copy to the completed application form)
Q13.1. Please indicate what policies and procedures are in place to ensure good
financial management within the lead organisation:
Q14. Have you or any of your partner organisations previously applied for funding
from any State Organisation/European Union institution for this, or for a similar
project?
YES 
NO 
IF ‘YES’ PLEASE GIVE DETAILS (including the name of the organisation)
Q14.1. Is this application pending a decision or has a decision been made by the State
organisation/European Union institution?
Q14.2. If the decision has been made please supply details:
Q15. Are you or any of your partner organisations planning to apply for funding to
any other State Organisation or European Union institution for this, or for a similar
project? YES 
NO 
IF YES PLEASE GIVE DETAILS OF THE PROPOSED APPLICATION, INCLUDING THE NAME
OF THE ORGANISATION WHO IS PLANNING TO APPLY FOR THIS FUNDING, TO WHOM
THE APPLICATION IS TO BE MADE AND THE AMOUNT REQUESTED:
Part 2: Project Details
Q16. Name of the specific project to be funded/co-funded by the Department of
Justice, Equality and Law Reform:
Q17. Please supply a description of your project:
Q18. What is the need being addressed by this project and how was it identified?
Q19. Who will directly benefit from your project e.g. people with disabilities, carers,
staff, volunteers, statutory groups, voluntary groups etc. For each category of
beneficiary identified please indicate the estimated total number to benefit from the
project.
Beneficiary Group
Approximate Numbers over the project duration
Q20. What is the coverage area for your project (national, regional, city, town)?
Q21. Please describe the key outputs that will result from the project?
Q22. Please describe the anticipated outcomes that your project will achieve?
Q22.1. How will the project benefit people with disabilities in your target area?
Q23. Can you indicate the level of involvement, if any, of disabled people in the
assessment of need, project design, proposed implementation and evaluation of the
project?
Q24. How will your project promote the development of collaborative approaches
between the partner organisations?
Q25. How will your project integrate with other agencies and organisations, not
formally participating in the project, in order to maximise the benefits and learning?
Q26. Please indicate how the proposed project is innovative, in that it promotes new
ways of delivering services and supporting persons with a disability.
Q27. How do you plan to disseminate and exchange information about the project and
its results in order to transfer project learning and models of good practice?
Q28. How will the project and its results be evaluated, both:
(i)
internally
(ii)
externally
Q.29. Do you want to continue this project after any potential EDS funding?
YES 
NO 
IF ‘YES,’ WHICH FUNDERS WILL YOU APPROACH? WHEN WILL YOU START TO LOOK
FOR OTHER FUNDS?
Q30. List similar projects carried out by the lead, or any other applicant organisation,
in the past (if applicable):
Part 3: Timescale and Financial Information
Q31: Please give details of the timescale of the project:
IT IS ESSENTIAL THAT PROJECTS ARE OPERATIONAL FROM NO LATER THAN
JANUARY 2009 AND MUST BE COMPLETED BY 31 MARCH 2010.
Q31.1 WHAT IS THE PROPOSED START DATE OF THE PROJECT? (DD/MM/YYYY)
________________________________
Q31.2 WHAT IS THE DURATION OF THE PROJECT? (IN MONTHS)
________________________________
Q31.3 WHAT IS THE PROPOSED COMPLETION DATE OF THE PROJECT? (DD/MM/YYYY)
________________________________
PLEASE NOTE THAT YOU ARE REQUIRED TO ATTACH AS APPENDIX 1 TO THIS
APPLICATION FORM, A MONTHLY TIMESCALE FOR THE IMPLEMENTATION OF
THE PROJECT.
Q32. What are the total project costs? This amount should include funding sought
under EDS + any matching funding.
THE TOTAL AMOUNT NEEDED TO UNDERTAKE THIS PROJECT IS €______________
Q33. What is the total amount of funding being sought under EDS?
THE TOTAL AMOUNT BEING SOUGHT UNDER EDS IS €_________________
Q34. In relation to expenditure for this project please detail any matching funding that
you (a) intend to apply for, (b) matching funding already applied for and pending a
decision, or (c) matching funding already applied for and secured:
(A) - matching funding that you intend to apply for:
(B) - matching funding already applied for and pending a decision:
(C) - matching funding already applied for and secured:
(D) – other funding sources and amounts – fundraising etc:
PLEASE NOTE THAT YOU ARE REQUIRED TO ATTACH AS APPENDIX 2 TO THIS
APPLICATION A DETAILED PROJECT BUDGET OUTLINING THE PROJECTED COSTS
OF THE PROJECT. THE BUDGET SHOULD ALSO INCLUDE A BREAKDOWN OF HOW
THE COSTS IN EACH OF THE BUDGETARY HEADINGS WERE CALCULATED IN
ORDER TO DEMONSTRATE THAT THE PROJECT OFFERS VALUE FOR MONEY (SEE
SECTION 9 OF THE EDS GUIDELINES FOR FURTHER INFORMATION)
Q35. Further Particulars: Please provide any additional information, which you
believe to be relevant to this application:
3. Final Checklist
The following documents must be enclosed with your application (where
applicable). Failure to supply these may result in your application not being
considered.
Please tick appropriate boxes below and/or enter N/A where applicable.
Application Form: Have you completed all of the relevant questions on the
application form (questions 1 to 35)? 
Time-scales: Have you attached as Appendix 1 a further document detailing
particulars of specific time-scales for implementation of the project? 
Budget: Have you attached as Appendix 2 a detailed budget for the project? 
Accounts: Have you enclosed a copy of your most recently audited accounts or a
certificate of compliance from a recognised financial authority? 
Legal Status: Have you attached a copy of your legal status? 
Declaration of Participation: Have you attached letters, as requested, of each
additional partner organisation? 
Tax Clearance Certificate: Have you attached a copy of your current Tax Clearance
Certificate or evidence of Charity Status (CHY Number)? 
Other Information: Have you attached any other relevant information that may assist
your application? 
Declaration: Have you read and signed the declaration in Section 4? 
4. Declaration
I, the undersigned, apply for a grant under the Enhancing Disability Services
Programme towards the project described in this application and appendices. I
declare that all the information given is true and complete to the best of my
knowledge and belief. I acknowledge that any funds awarded must be used for the
purpose stated and not used to replace existing funding.
I also accept, as a condition for the allocation of funding, that it involves no
commitment to any other grants from the Department of Justice, Equality and Law
Reform. I, the undersigned, agree to have the project monitored by Pobal and the
Department of Justice, Equality and Law Reform or its agents and to allow access to
premises and records, as necessary for that purpose.
Freedom of Information Act.
Any information provided by you in this application may be subject to release in
accordance with the obligations of Pobal and the Department of Justice, Equality and
Law Reform under the Freedom of Information Act, which came into force on 21
April 1998. If you believe that any of the information supplied by you should not be
disclosed because of its sensitivity, you should identify this information and state the
reasons for its sensitivity. Pobal and/or the Department will consult with you about
this sensitive information before making a decision on any Freedom of Information
request received.
Name (BLOCK CAPITALS)_______________________________
Signature______________________________
Date__________
Completed Applications forms and all supporting documentation should be forwarded
to:
Anna Buzzoni
Enhancing Disability Services Programme
Pobal
Holbrook House
Holles Street
Dublin 2
On or before 5pm, Friday 27th June 2008.
Envelopes should be clearly marked ‘Enhancing Disability Services Programme.’