EARLY YEARS CAPITAL 2016
APPLICATION FORM
WORD VERSION 15.02.2016
THIS FORM IS FOR INFORMATION ONLY
YOU MUST APPLY VIA OUR ON-LINE APPLICATION
FORM WHICH WILL BE AVAILABLE IN DUE COURSE VIA
OUR PIP SYSTEM
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Section 1 Instructions

Button link to the applicant guidelines to Early Years Capital 2016
Instructions for Completing your Application
Before commencing this application process please ensure that your service fulfils the
following basic eligibility requirements:

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Be an existing private or community childcare provider i.e. have a Department of
Children and Youth Affairs (DCYA) Reference Number
Be approved for Early Childhood Care and Education (ECCE) in 2015
Be tax compliant with an up to date Tax Clearance Certificate (TCC) or have a Tax
Clearance Access Number (TCAN) and Tax Registration Number (TRN)
Have no outstanding debt to the DCYA, unless there is an agreement in place with
DCYA to repay the debt
Completing the ON-LINE FORM
Step 1
Step 2
Step 3
Step 4
Step 5
Before you begin completing your application form please read the Applicant
Guidelines for Early Years Capital 2016 (link button to the guidelines) and
Early Years Capital FAQs (link button to the FAQs)
Please complete the application form in full. Please note the following: You may exit and save the form as a “draft” as many times as is required.
 Ensure that all supporting documents, such as quotations are attached within
the form where requested. Ensure you scan your documents using the lowest
resolution, before attaching to the form and one document per scan and
attachment. Refer to our “How to Guide” [Button Link to the Guide] for further
instructions.
 The space given in each field of the form is limited to a fixed number of
characters. You must restrict the content of your response in each of the fields
to the space provided. Spaces and lines are counted towards character limits
 You will only be able to submit the application form once all mandatory fields,
donated by * are completed.
Submit your application form. Refer to the “How to Guide” to complete this
step. Please note: Once you submit your on-line application form, the form cannot be edited and
no additional documents can be attached to the on-line form
 No application forms, information or submissions will be accepted via e-mail or
hard copy
Pobal will review your application and make recommendations to the
Department of Children and Youth Affairs (DCYA), who will make the final
decision on your application. The decision will be communicated to you in writing
by DCYA.
Should your application be successful, Pobal will be responsible for issuing you
with your grant agreement and issuing payments based on your signed grant
agreement and subsequent expenditure claims.
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Section 2 Application
2.1 Enter your DCYA Reference Number (Applicant ID)
2.2 Application Status: (New, Draft, Submitted - Autofill)
Section 3 Service Details
3.1 Local County Childcare Committee (CCC)
Autofill
3.2 DCYA Reference Number
Autofill
3.3 Facility Name
Autofill
3.4 Facility Address (Street, Street, Street, County)
Autofill
3.5 Applicant Name
Autofill
Organisation/Legal Name as it appears on your ECCE contact
3.6 Organisation Primary Contact
Autofill
3.7 Primary E-mail
Autofill
3.8 My primary e-mail is incorrect
3.9 If yes, insert new e-mail address
Select Y/N
Insert e-mail
address
This is the e-mail address which will be used for correspondence with you in
relation to the decision on your application and any subsequent grant
agreement that will be issued should you be successful
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Section 4 Capacity and Attendance
Please complete the following tables in relation to the number of places your service is in a
position to offer i.e. Services Offered
Children enrolled = How many children, by service offered, are currently enrolled to attend
your facility?
Vacant Places Available = the number of places your service is in a position to offer per
day, minus the current number of children enrolled. This may not exceed the maximum
capacity as set out in the TUSLA Inspection Report (button link to report)
Waiting List = how many children, by service type, are on your waiting list for places
immediately? If you have no children on waiting lists (or do not operate one) please enter
zeros.
Services Offered
Yes/No
Children
Vacant Places
Enrolled
Available
Waiting List
Total: Autofill
Full day care
Part time care
Sessional a.m.
Sessional p.m.
Afterschool
Breakfast club
Drop in/occasional
Overnight Service
The number of places your service is in a position to offer by Age-Range
Age Band
Yes/No
Children
Vacant Places
Enrolled
Available
Waiting List
Total: Autofill
Under 1
Under 2
Under 3
Under 4 ½
Under 6
6+
4
Specifically in relation to your Early Childhood Care and Education places
(ECCE) service please complete the following:-
Children Enrolled as at 31 January 2016 (ECCE)
Vacant Places Available as at 31 January 2016 (ECCE)
Number of Children Enrolled for September 2016 (ECCE)
Waiting List for September 2016 (ECCE)
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SECTION 5 PROJECT PROPOSAL
5.1
Number Of Additional ECCE
How many additional ECCE places do you intend to
provide by the 1st September 2016
You must intend to provide additional places in September 2016 to be eligible to apply. If you answer “0”
you will not be able to complete the remainder of the application.
5.2
Explain how you have identified the demand for the additional ECCE places in your
service as outlined in Q3.1
Include the key data and data sources or references
used by you to verify this demand. Link button to Pobal Maps
5.3
Select type of Project Proposal

Capital Works

Equipment Purchase
You may select one or both of the above
5.4
Provide a brief description of the Capital Works to be undertaken
You only be required to complete this if you selection Capital Works at 5.3
5.5
Y/N
Does your project proposal require planning
permission?
5.6
Insert Your Planning Reference Number
Insert Planning Reference
Number
You will only be required to complete this if you selection Capital Works at 5.3. If successful and
you do require planning permission you will be required to submit evidence of full planning
permission and evidence of ownership, prior to receipt of your first payment.
5.7
Provide a brief description of the Equipment to be purchased
You will only be required to complete this if you select equipment purchase at 5.3
5.8
Describe why these improvements and/or equipment are necessary to enable the
additional ECCE places to be provided within your service.
5.9
Y/N
Is your organisation registered for VAT?
If registered for VAT, you must enter ALL figures below exclusive of VAT
5.10
Enter to the total cost of the proposed project €
€ Total Cost of Project
5.11
Enter the amount of the grant requested €
€ Amount of Grant Applied For
This may be the same as the figure in 5.10 but must not exceed €10,000.
5.12
Amount to be provided by the applicant €
Autofill
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SECTION 6 Explanation of Costs
Number of Quotes/Tenders to be attached
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Attach one valid quote for each piece of equipment cost applied for up to the value of
€5,000
Attach a minimum of 3 written quotations for any piece of equipment applied for
which is greater than €5,000
For building works and repairs less than €5,000 attach one written quote/tender
For building works and repair greater than €5,000 and less than or equal to €25,000
a minimum, attach a minimum of 3 written quotations/tenders
For building works and repairs greater than €25,000 refer to the public procurement
guidelines
For a quote or tender to be considered valid it must contain the following
information:





6.1
Be dated in 2016
Be on Headed Paper
Include a Value Added Tax (VAT) number
Be clearly itemised
Where one or more quote or tender is required they must be from separate provider
Please complete the table below outlining all the costs for your project proposal.
If you are registered for VAT the figures inserted at “Selected Quote” must be net of
VAT, however the attached Quotation/Tender must show and be inclusive of the VAT.
Description
Capital Work
Costs
e.g. shelving,
flooring, painting,
remove wall;
build toilet
facilities
Name of Quotation
Attach
Selected Selection
Supplier Amount Quotation
Quote
Reason
or Tender
€ two
decimal
places
€ two
decimal
places
€ two
decimal
places
Sub-Total
Capital Works
Autofill
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Description
Equipment
Insert each piece
of equipment
Name of Quotation
Attach
Selected Selection
Supplier Amount Quotation
Quote
Reason
or Tender
€ two
decimal
places
€ two
decimal
places
€ two
decimal
places
€ two
decimal
places
Sub-Total
Equipment
Costs (B)
Total Costs
Autofill
Autofill
and must
= 5.10
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Section 7 Disclaimers
Please read carefully
By submitting the application, the Legal Owner/ Board of Directors/Management Board
declare that the information provided in relation to the organisation described in this
application is true and complete to the best of their knowledge and belief.
The Legal Owner/Board of Directors/Management Board acknowledges that any funds
awarded must be used for the purpose stated and not used to replace existing funding. The
Board also understands that information supplied in, or accompanying, this application may
be made available on request under the Freedom of Information Acts 2014
The Legal Owner/ Board accepts, as a condition of the award of a grant, that it involves no
commitment to any other grants from The Department of the Children and Youth Affairs or
Pobal. The Board are agreeable to having the project monitored by Pobal and The
Department of the Children and Youth Affairs and to allow access to premises and records,
as necessary, for that purpose.
The Legal Owner/Board of Directors/Management Board also accepts that Pobal may
contact Funder Organisations or Government Departments to discuss this application and
previous funding awarded, as part of the appraisal process.
Please read carefully:
It will be a condition of any application for funding under the terms and conditions of the Early
Years Capital 2016.
i. The Department of the Children and Youth Affairs and Pobal shall not be liable to the
applicant or any other party in respect of any loss, damage or costs of any nature arising
directly or indirectly from:
a) The application or the subject matter of the application;
b) The rejection for any reason of any application.
ii. The Department of Children and Youth Affairs, its servants or agents shall not at any time
in any circumstances be held responsible or liable in relation to any matter whatsoever
arising in connection with the development, planning, construction, operation,
management and/or administration of individual projects.
Disclosure under the Freedom of Information Act
The Department of the Children and Youth Affairs wishes to remind applicants that the
information contained in the application form and supporting documentation may be
released, on request, to third parties, in accordance with the Department’s obligations under
the Freedom of Information Act 2014.
You are asked to consider if any of the information supplied by you in applying for funding
under the Early Years Capital 2016 should not be disclosed because of sensitivity. If this is
the case, you should, when providing the information, identify same and specify the reasons
for its sensitivity. The Department of the Children and Youth Affairs and/or Pobal will consult
with you about sensitive information before making a decision on the release of such
information. The Department of the Children and Youth Affairs and/or Pobal will release, on
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request, information to third parties, without further consultation with you, unless you identify
the information as sensitive with supporting reasons.
If you consider that some of the information is sensitive, you are required to clearly identify
such information when submitting your application.
If you do not identify any of the information supplied in the Application Form and
supporting documentation as being sensitive you are acknowledging that any, or all of
the information supplied, will be released in response to a Freedom of Information
request.
Request for non-disclosure of sensitive information (if applicable)
Outline the sensitive information
Outline the rationale for non-disclosure under the Freedom of Information Act
LOBBYING ACT 2015
Under the Lobbying Act 2015, applicants should note that Pobal is required to make
information available to the public on the identity of those communicating with Pobal in
relation to prospective funding decisions.
Canvassing by an applicant or a third party may disqualify an application.
By submitting this application the Owner/ Board of Directors/Management Board
acknowledges that they have read, understood and accepted the above points
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SECTION 8 SUBMISSION OF APPLICATION
8.1
8.2
8.3
8.4
8.5
8.6
8.7
I confirm that no cost, or part thereof, of any element of this
proposal outlined in this application has been already been
expended or purchased. All items or services purchased will be
post the approval date of this application.
I confirm that the requested funding will be fully spent and reported
by the dates outlined in the applicant guidelines
I confirm on behalf of the legal owner that where the total project
cost is greater than €10,000; I/we have in place the additional funds
to complete the project and will submit evidence of this will our
expenditure claims.
Note: Click/Enter N, if your total project cost= amount of grant
applied for.
I confirm my commitment to ensure that suppliers or providers for
costs of €10,000 or more (inclusive of VAT) will have a valid TCAN
or Tax Clearance Certificate or Valid C2, which I will retain for
inspection up to the 31st December 2022.
I confirm that I have the permission of the legal owner to carry out
the any refurbishments, fit out or alterations as outlined in this
application: Note evidence of this must be available for future
expenditure claims or inspections.
I declare that that by submitting this application that the Board of
Management/Service Owner accepts the conditions outlined in the
Section 5 Disclaimers
I confirm that the Board of Management/Service Owner has
authorised the submission of this application
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
SUBMIT BUTTON
If you have not completed all the mandatory fields donated by * or there are other error
messages, your application will not be submitted, when you hit this button on the on-line
application form.
IF YOU EXPERIENCE DIFFICULTIES PLEASE CONTACT OUR HELPLINE AS
FOLLOWS
[email protected]
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