Grants Over £15k

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Applicant Details

First Name

Last Name

Telephone

Legal Name of Organisation

Organisation Website

Address Line 1

Address Line 2

City

Postcode

Organisation Type

Other - please provide details

Charity / company number

What is your organisation’s mission? Include information on the number and description of beneficiaries you help each year, and where you work. (100 words.)

Fund Name

Account ID

Applicant Details

Title of Project

Amount Requested from RPLC

Please enter a number without any currency signs, e.g. 1000 rather than £1000

Total Cost of Project

Please enter a number without any currency sign, e.g. 1000 rather than £1000

% requested from RPLC

Please enter a number only, without a percentage sign

% secured from other funders to date

Please enter a number only, without a percentage sign

Project Start Date

Project End Date

Number of people within the RPLC benefit area expected to be supported by the project?

Number of people across LBRuT (including the RPLC benefit area) expected to be supported by the project?

Total number of people expected to be supported by the project (including outside of LBRuT)?

Project outline [200 words]

Problem that the project is aiming to address [100 words]

How will your project address this problem? [200 words]

What are the main activities/outputs for this project? Please state at least two.

Activities/Output 1 [75 words]

Activities/Output 2 [75 words]

What are the outcomes/results that you expect to achieve as a result of this project? (Please list at least 2)

Outcomes/Result 1 [75 words]

Outcomes/Result 2 [75 words]

How will you monitor and evaluate the achievement of the outcomes listed above? [100 words]

Please provide a breakdown of how funds will be used

What do you hope the longer term impact of the project will be?

How have you consulted service users in designing this project?

Will you be working with a partner organisation on delivering this project? If so, please describe (max 100 words)

What are the additional funds you will need to secure and how do you plan to achieve this?

Please attach the budget for your project. If costs have been apportioned, please highlight this on the attached budget

What contingency plans are there if this application is unsuccessful?

Where do you see this service in three years’ time?

Which of RPLC’s scheme objects does this application primarily fit under?

Please Upload

GDPR policy

Safeguarding Policy

Reserves Policy

Risk management register

Copy of last finalised annual accounts if not a registered charity (registered charities’ accounts will be checked online).

Scanned or downloaded evidence of your organisation’s bank account details showing organisation name, address, sort code and account number in the form of a recent statement (last 3 months).

Financial Information

Financial data - please enter all amounts as numbers without currency signs

	This Year	Previous Year
Cash at bank
Unrestricted reserves
Reserves represent how many months of operating costs?

Please identify which of the following you are able to supply, and upload (if the information already exists)

Please upload a copy of the financial data type selected above.

Date financial document was compiled

When were the accounts signed?

What is your financial year end date?

Day

Please specify a number, 1-31

Month

Please upload a copy of the latest management accounts.

Please confirm all staff are paid the London Living Wage

Yes, I confirm all staff are paid the London Living Wage

List up to four grants you've received in the last 12 months (Not RPLC, HF, BF, LBRuT)

Have you any particular financial risks and how are they managed?

How would you describe your current financial position?

Governance

How many Trustees do you have?

How often do they meet?

How would you describe the role of the Board (supportive, critical, strategic)

Who is the named Safeguarding officer?

When was the Safeguarding Policy last reviewed?

What governance issues or changes have there been in the last year?

Who is the person responsible for data protection?

When was the Data Protection Policy last reviewed?

Organisation Details

What is the principal issue your organisation is trying to address?

How do you raise awareness and promote your services?

What similar local organisations are there?

What is your involvement in commissioning or the local voluntary sector?

If your organisation is part of a larger group, what is its name?

Who do you help? Age, gender, BEM, deaf, disabled, LGBTQI

Main Area of Activity

Have you received funding from RPLC previously?

YesNo

Please confirm the following (requirements to submit)

Bank Account Number

Please enter your bank number without spaces

Sort Code

Please enter your sort code as digits, without spaces or dashes

By submitting this form, the applicant agrees:

That they are willing to take part, where appropriate, in any publicity activities
That they understand that funding is conditional on any safeguarding incidents or data breaches involving the organisation being reported to RPLC.
That they understand that this funding is conditional on reports being provided on the progress of the organisation against the aims set out above.
That, to the best of their knowledge, the information provided on this application form is correct.

All information will be treated in the strictest confidence and will not be divulged without prior agreement of those concerned. All data will be stored securely.

I agree to the above

Signed (print name)

Role

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Contact Information