Section 1 - Organisation Organisation Name and Address Details Name of your organisation House number City/Town* Postcode* General/Office Email Street* County* Website (if any) General/Office Telephone Main Contact Person These are the details that will be used for correspondence purposes. Title MrMsMrs Forename(s) Surname Job title Work/Office Phone Email Address Mobile Phone Use organisation's address for correspondence House number County Postcode Street City/Town Organisation Start Date* What type of organisation are you? Select as many as appropriate A registered charityCompany limited by guaranteeUnincorporated club or associationCommunity interest companyCharitable Incorporated Organisationothers if other, please explain Are you part of a larger regional or national organisation? yes If yes please state name of organisation Governance Please confirm you have at least 3 unrelated trustees/committee members responsible for your organisation/group and its activities yes Organisations Income Over Last Accounting Year ( £ ) Please briefly describe the overall aims and objectives of your organisation and the activities or services your organisation provides (up to 250 words) Section 2 - Project Project Details Project Name Project / funding start date Project / funding end date Which area will the activity take place in? Christchurch TownJumpers / Fairmile / St Catherines HillHurn / CommonsSomerfordMudeford / StanpitHighcliffe / WalkfordBurtonAll Which area (estate, town, village, borough or wider area) do most of the people who benefit come from What are you applying to us for and who will benefit? (up to 400 words) What difference do you hope this will make to people’s lives If this project does not have a fixed end date, how will you continue to fund the project when the funding ends Section 3 - Impact Beneficiaries How many people will benefit from this funding? Estimated number of volunteers involved Primary Beneficiary - Select a single option to represent the primary beneficiary group for this grant Choose an optionBlack, Asian and minority ethnicCarersChildren and young peopleEx-offenders/offenders/At risk of offendingFamilies/Parents/Lone parentsHomeless peopleLesbian, gay, bisexual and transgendered groupLocal residentsLong-term unemployedMenNot in education, employment and training (NEET 16-24)Older peoplePeople with alcohol/drug addictionsPeople in care or suffering serious illnessPeople with learning difficultiesPeople with low skill levelPeople with mental health issuesPeople with multiple disabilitiesPeople with physical difficultiesPeople Living in povertyRefugees/asylum seekers/immigrantsVictims of crime/violence/abuseWomen Age Profile Primary age group - select a single option to represent the primary age group for this grant Choose an optionEarly years (0-4)Children (5-12)Young people (13-18)Young adults (19-25)Adults (26-65)Seniors (65+)All ages Section 4 - Project Budget and Consent Project Budget What is the total cost of the project? How much money are you applying to us for? Budget Breakdown Summary. Either give details here or if you have a prepared budget, download it in the next box. Upload Your Detailed Budget If the grant does not cover your total project costs, please tell us whether the remaining funds have already been raised, or where they will come from. Supporting Documents • Please click on the attachments button at the bottom of this page to upload your supporting documents. Whenever possible, please submit attachments as pdfs. (We appreciate that new and emerging groups may not be able to supply supporting documents - alternatives for these groups indicated below) 1. A copy of your governing document (eg constitution, memorandum & articles or set of rules). 2. A copy of your most recent set of annual accounts 3. A copy of a bank statement no more than 3 months old (clearly showing account name, number and sort code) 4. A copy of your safeguarding policy If you experience difficulties uploading documents please email them to firstname.lastname@example.org when you submit your application. File Size limit 5MB per file Please provide any further information that will assist the Trustees to consider your application If the Trustees agree to make a grant, please give the details of the account to which the monies should be sent. If these differ from the details on the Bank Statement provided, please give reasons. Alternative support for New & Emerging groups Groups with less than 6 months direct service delivery experience should provide the details of a organisation/referee who can endorse you AND receive & manage the money on your behalf. Referee forename Referee surname Referee company name Referee position Referee email Referee phone Please advise how long you have been running and how you are able to give assurances that the project will be run appropriately. Declaration I confirm that the information given on the application form is true and my organisation has formally agreed that I can act on their behalf. I confirm that I have attached all required supporting documents. yes If funded, I agree to the following (YOU MUST TICK THE BOX UNDERNEATH THE FOLLOWING TERMS AND CONDITIONS TO CONFIRM): 1. The organisation and main contact details, and the details of the application, can be shared with the Trustees of Christchurch Charitable Trust 2. The grant can only be used for the purpose for which it has been granted. 3.The grant applicants must normally start the funded activities within three months of receipt of the funds unless agreed otherwise. 4. Any funds remaining after the end of the grant period and any agreed extensions, must be returned to Christchurch Charitable Trust 5. The relevant Safeguarding policies are to be adhered to at all times. In the case of New & Emerging groups who do not have a Safeguarding policy, they should not have direct unsupervised contact with children or vulnerable adults and all workers should be aware of how to raise any Safeguarding concerns by referring to BCP Council websites as appropriate 6. Grant recipients will be required to complete an End of Grant Report, to confirm how the funds have been used and benefits that have been provided to the community. 7. Unless agreed otherwise, it is acknowledged the Christchurch Charitable Trust may refer to the giving of the grant for the purposes of publicity. 8. We reserve the right to recover the Grant in whole or in part or to reclaim any equipment purchased under this agreement, should the funded activities not go ahead or the organisation cease to exist. 10. The grant recipient is responsible for insurance against risks which may arise from any activities or property which is grant aided, including loss or personal injury to persons undertaking those activities. Christchurch Charitable Trust is not liable for any contingency involving property or activities for which they have provided grant aid in whole or in part. 11. The grant recipient should ensure services provided by and through the grant are underpinned by equality and diversity principles. Ensuring there is no discrimination on the grounds of race, colour, ethnic or national origin, disability, age, gender or gender identity, sexual orientation, marital status, or any religious affiliation. Providing equal access to employment/volunteering opportunities and services for your beneficiary group. Tick to confirm acceptance of the above terms and conditions WHEN YOU PRESS SUBMIT, THE APPLICATION WILL BE SENT TO US AND A COPY WILL BE EMAILED TO YOU FOR YOU TO RETAIN FOR REFERENCE.