Please note that applications will not be processed unless all required information is provided. Additional information can be uploaded at the end of this application.

* denotes fields that are mandatory

Stage

Organisation Name

Grant Application Record Type

Close Date

Approval Status

Funding Category

Funding Category Applied For

Category of Grant

1. Group Details

1.1 Name of Organisation

1.2 Address of Organisation

1.3 Name of Project for which funding is sought

Project refers to activity / equipment purchase / event for which funding is being sought

1.4 Name of Key Contact Person

1.5 Position of Contact Person

1.6 Address of Contact Person

1.7 Mobile Number of Contact Person

1.8 Email Address of Contact Person

Please Note: These contact details will be used for all communication regarding this application

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2. Project or Activity or Event Detail

2.1 Describe in DETAIL the proposed project on which your group intends to use Active South Dublin Funding. Please include the target audience(s) for your grant *

3. Financial Information

3.1 What is the full cost of your project €

3.2 Please provide a full breakdown of costs. Note that the items listed below must total the full cost of your project and will be the only items considered.

Item	Cost of item €

Please Note:
Upload a seperate sheet if you do not have room to list a full breakdown of costs.

3.3 Total amount for which your are applying to Active € South Dublin

3.4 Amount of Own Funds Allocated to this project €

Please note should total cost of project exceed maximum grant available, the group must have own funds available to cover the additional costs.

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4. Bank Details

Name of Bank

BIC

IBAN

Please Note: To enhance your funding application you should attach your organisation’s most recent bank statement at the end of this application

5. Other Details

5.1 Please state how any contribution from Active South Dublin will be acknowledged.

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6. Relevant Supporting Documentation

If you wish to attach documentation to this grant application, please do so below.

Attach Document here

If you have any more attachments, please email them directly to info@activesouthdublin.ie, stating the name of your organisation in the subject line.

7. Declaration

I have read the information regarding the criteria for the community funding scheme and I understand the conditions of the funding. I hereby declare that the information supplied on this funding application is accurate and complete. I understand that all of the information provided will be retained by South Dublin County Council and may be made available to other departments within the Council, as deemed appropriate. It should be noted that the Freedom of Information Act applies to all records held by South Dublin County Council.

Click here to view South Dublin County Council Privacy Statement

Please tick this box to confirm that you have read and are in agreement with South Dublin County Council Privacy Statement

Declarer's Name

Declarer is the person authorised by his/her group to submit this application

Declarer's Position in the Org

Declarer's Position if Other

Name of Chairperson

Email of Chairperson

Name of Secretary

Email of Secretary

You will receive a confirmation email when you submit this application.