"*" indicates required fields Step 1 of 5 20% Community Grant Application Form PLEASE NOTE: Completed Application Forms are open to public inspection Community Grant Application Form: v1.2 NOTE FOR APPLICANTS: Excerpt from 4.3 of the Community Grants policy - to be eligible for a Community Grant an organisation must: - Be able to provide a copy of its latest annual accounts and most recent bank statement. - Have a bank account operated by a minimum of at least two joint signatories. - Where appropriate, be able to demonstrate that Child and Vulnerable Adult Safeguarding measures are in place. This will be usually in the form of an appropriate policy that requires those working directly with children and vulnerable adults to be DBS checked and approved. Contact InformationName of Organisation*Position in Organisation*Name of Applicant* First Last Phone Number*Email Address* Organisation Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country About your OrganisationOrganisation Type* Educational Organisation Community Group/Club Registered Charity Other Do you have a constitution or governing body?* Yes No What is the main purpose of your organisation?*How many years has your organisation been in existence?*How many trustees/committee members do you have?*How many staff does your organisation employ?*Roughly how many volunteers do you regularly have?*Please provide details of your organisation’s membership* Add RemoveHow is your organisation managed?* Project detailsPlease give a brief outline of the project you’re seeking fund for*Please include specifics of what the funding is needed for and whether your project involves collaboration with other groups.How many people do you expect to benefit from your project?*Project scheduleHow long will your project last?*When will your project start?*Project Costs*Total Cost of your ProjectCost £ Add Remove*How much are you seeking as a grant from Gainsborough Town CouncilCost £ Add RemovePlease provide a breakdown of your project costs in the table below.*ItemCost £ Add Remove(Please add rows as required, one row per item please)Have you applied for funding for this project from any other funders? Yes No Total Project Cost per Item*Taken from the breakdown of your project costs.If yes, please give details about contributions below: Evidence of need*Please outline what steps you have taken to identify that there is a need for your project or confirm how you know that there is a need for your project?Attachments Drop files here or Select files Max. file size: 8 MB. If there are any supporting documents that you would like to provide, please include them when you submit your application. Please upload any relevant documentation.SubmissionIf there is any additional information relating to your project that you want to make us aware of.Consent* I declare that any grant made will be used solely for the purposes outlined in this application.I understand that Gainsborough Town Council reserves the right to reclaim the grant in the event of it not being used for the purpose specified.Consent* I agree to the privacy policy.I agree the Council can retain my personal information so it can process and manage my community grant application. You can read the council’s General Privacy Notice here: Privacy Policy - Gainsborough Town Council (gainsborough-tc.gov.uk)Signature*This field will be classed as your digital signature upon submission of this form Date* Δ
