Application Form

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Welcome to the Heart of England Community Foundation application form for the NNS Digital Fund. 

Before you proceed with your application, please read the following information carefully.

You will process my details in accordance with the following policies and information:

Questions followed by an asterisk are mandatory and must be answered.

You can save your progress at anytime by clicking 'save my progress and resume later'.

Contact Details

The contact person should be someone who has a good knowledge of the application as this is the person we will contact if we have any queries.

Organisation Details

As it appears on any governing documents.


If the organisation doesn't have an independent location we will use the contact details of the primary contact.

The telephone number should be one at which the organisation is easily contactatable, especially during office hours. 

Staying connected online

We'd like to keep in touch with you during the grant application process and beyond, so please  provide your organisation's website and social media details if you have any.

Organisation Details

Organisation legal status (select all that apply)

A registered charity is an organisation that is established for charitable purposes and registered with the Charity Commission. 

Groups made up of members of the local community, for example Residents Associations.

An incorporated firm without share capital, in which the liability of its members is limited by the amount each one of them undertakes to contribute at the time the firm is wound up, usually £1.

Introduced in 2005, CIC’s, are designed for social enterprises that want to use their profits and assets for the public good.

You must select at least one status from the list above
Calculations


If your project, activity, or service contains any training, education, counselling etc please list qualifications of those delivering these sessions. Also list any memberships or accreditation's your organisation may have e.g. British Gymnastics, Football Association, English Cricket Board.

Organisation Details



£
£
£

Unrestricted Reserves - Money shown in your accounts at the end of the financial year that can be spent on whatever the management committee see fit. The Charity Commission recommends organisations have 3-6 month unrestricted reserves.


Reserves - Money shown in your accounts at the end of the financial year. These are generally categorised as Restricted and Unrestricted Reserves.
Restricted Reserves - Money shown in your accounts that are to be used only for certain things. Such as other grants awarded for specific projects.


How many of each of the following are involved in the organisation?

Bank details

You will need to attach a bank statement from within the last three months at the end of this application so that we can check the account you want this grant to be paid into, if successful.

Bank address

Project, Activity or Service Details

If you do not have a name for the project, activity or service that is ok. 

Our average turnaround time for applications is 8-10 weeks. Please allow a minimum of 12 weeks from submission of your application.

This could be up to a period of 12 months from your start date, but this can be less depending on how long you wish to deliver your project for. 

If your project, activity or service is on-going, you should enter the start and finish dates of the funding period.


Please provide estate, town, village, neighbourhood name and postcode




Budget

To help us understand what you're planning to spend the money on, we would like you to provide a breakdown of your costs



E.g. how many hours, how many sessions, cost per hour and duration of delivery, salary per annum.

£

£


E.g. Travel costs

£

£


E.g. room hire cost per hour, how many hours?

£

£

E.g. leaflets, advertising costs


£

£



£

£

E.g. Equipment


£

£




£

£

Project, Activity or Service Costs

£

These are the amounts you've entered on the previous page

£

These are the amounts you've entered on the previous page




e.g. Other funders, covered by own reserves etc. Have you already secured some elements of this?

Additional documents

If you are applying to us for the first time using this form, you need to attach all of the following documents. If you have applied to us using this form within the last 12 months, you only need to attach a recent bank statement.







Heart of England Community Foundation Declaration

By ticking the box below:

  • You accept that if you leave the organisation or can no longer fulfill your responsibilities, or someone else takes over responsibility for the grant on behalf of the organisation, you must inform us immediately.
  • You accept the terms and conditions of the grant as they are set out in this application form and the guidance notes.
  • You certify that the information contained in this application is correct and that you are authorised by the organisation to accept these conditions on their behalf.
  • You will only spend the grant for the purposes outlined in this application unless you have received written confirmation, from the Foundation, that you can make a variation of spend.
  • You accept that the Foundation will, under no circumstances, be liable for any damage, injury or loss of any kind whatsoever to any property or persons occurring as a result of activities undertaken with this grant.
  • You will ensure that all necessary permits and licenses have been obtained for any event or project funded by the grant and that the event or project complies with all relevant regulations.
  • You acknowledge that you cannot sell or dispose of any equipment or other assets funded or part funded by the Foundation without first receiving written permission.  If any equipment or assets are sold within their working life without such undertaking, the Foundation can ask for a percentage of the original grant to be re-paid.
  • You confirm that the grant will not be used for the provision of services to asylum seekers when those services are inconsistent with immigration laws or Home Office policy. You understand this includes, but is not limited to: the promotion of work based training to asylum seekers; the provision of employment to asylum seekers unless they are otherwise permitted to take employment; and the provision of services or activities, to asylum seekers, which are intended to assist with the integration of refugees.
  • You accept that you must keep all financial records and accounts including receipts for items bought with the grant for at least 6 years. These must be made available to the Foundation if requested.
  • You give permission for the Foundation to record the information in this form electronically and to contact your organisation by phone, mail or email with regards to this application.
  • You accept that Heart of England Community Foundation may follow up on successful applicants and potentially feature them in publicity activities.
  • You accept that if your application is successful, that you are willing to take part in, where appropriate, in any publicity activities.
  • You agree to Heart of England Community Foundation collecting, processing, storing and sharing information provided on this application, as part of the assessment and monitoring process in line with their Privacy Policy. This includes the sharing of information on grant applicants with grant panel members, donors and approved suppliers e.g., marketing agency. We will also publish a full list of all successful grant recipients externally. This includes group/organisation’s name, amounts awarded, location and purpose of grant.
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