Play Area Renewal Fund
Application Form
Official Use Only
| Ref: | |
|---|---|
| Date Rec’d: | |
| DoFA: |
IMAGE: The Orkney Islands Council coat of arms appears above the words “ORKNEY ISLANDS COUNCIL”. The page is titled “Play Area Renewal Fund” with “Application Form” beneath it.
1. Details of Organisation
| Name of organisation (as it appears on constitution): | |
| Name of Main Contact. | |
| Position in Organisation. | |
| Address. | |
| Telephone Number. | |
| E-mail Address. | |
| Formal postal address for organisation. | |
| What year was the organisation established. | |
| Is organisation a registered charity? | Yes. No. |
| If yes, reference number. | |
| Is your organisation VAT registered? | Yes. No. |
| If yes, registration number. | |
| Chairperson. | |
| Treasurer. | |
| Secretary. | |
| How many committee members are in your organisation? | |
| Describe the main purpose/ activities of your organisation? |
2. Project Details
Proposed project (please give a brief description here, and accompany your application form with a Development Plan – please refer to the Guidance Notes:
| What percentage of the community could benefit from your project? | % |
| When do you anticipate the project to start? | |
| How long do you expect the project to take? |
3. Cost of Project
| Item/Activity. | Amount. |
|---|---|
| Purchase of land/buildings. | £ |
| Building construction. | £ |
| Refurbishment of property. | £ |
| Equipment. | £ |
| Professional fee. | £ |
| Other (please specify) | £ |
| £ | |
| £ | |
| £ | |
| Total Project Cost. | £ |
4. Funding Sources
Actual Grants Already Awarded
| Name of Funding Bodies. | Amount. |
|---|---|
| £ | |
| £ | |
| £ | |
| £ | |
| £ | |
| £ | |
| £ | |
| £ | |
| Own Resources (5% minimum). | £ |
| Sub Total (a) | £ |
Other Grant Assistance Applied For
| Name of Funding Bodies. | Amount. |
|---|---|
| (CDF) | £ |
| (Crown Estate Funding) | £ |
| £ | |
| £ | |
| £ | |
| £ | |
| £ | |
| £ | |
| Sub Total (b). | £ |
| Total funds awarded/applied for (a) + (b). | £ |
| TOTAL FUNDS APPLIED FOR FROM THE PLAY AREA RENEWAL FUND (Max £25,000). | £ |
5. Bank Details
| Bank/Building Society Name. | |
| Bank/Building Society Address. | |
| Name of Account. | |
| Sort Code. | |
| Account Number. | |
| Building Society Roll No. | |
| PLEASE NOTE: All grant payments will be paid by BACS transfer. | |
| How many people have to sign cheques to release funds from this account? |
6. Enclosures
To assist in the processing of your application, you are asked to contact the OIC Sport and Leisure Service by telephone to 01856 873535 or by e-mail to leisure.culture@orkney.gov.uk who will advise you of the specific information you will require to submit with your completed application form, which will include some or all of the following (a Development Plan must accompany all applications):
a) Copy of the organisation’s constitution, or equivalent.
b) Costings / quotations for all items of expenditure (please refer to Guidance Notes).
c) Copies of recent audited accounts / income and expenditure statements, or projected income and expenditure statements in the case of a new organisation.
d) Development Plan, including projected cashflow, timescale and full details of project (please refer to Guidance Notes).
e) A recent bank statement.
f) Evidence of efforts made to secure match/external funding prior to application being made (please refer to Guidance Notes).
g) Copy of Title Deeds identifying ownership, Lease Agreement(s) or relevant permissions (where applicable).
h) Feasibility Study (where applicable).
i) Architect’s Plans (where applicable).
7. Declaration
I declare that, to the best of my knowledge, the information given in this application and the enclosed information is correct.
| Signed: | Date: | ||
| Print Full Name: |
Please return completed form, with supporting documentation, to:
Orkney Islands Council,
Education, Leisure and Housing – Sport and Leisure,
Orkney Islands Council,
School Place,
Kirkwall,
KW15 1NY.
General Notes
Applications are considered by Orkney Islands Council’s Education Leisure and Housing Service.
Applications should be submitted prior to the commencement of the project as retrospective assistance will not be provided.
Any offer of grant will be subject to a formal agreement being completed. No payment of grant can be made until that formal agreement has been concluded.
Please refer to the Guidance Notes for further information.