Green Community Grant - Application Form

Your Application

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* 1. Have you read and understood the Green Community Grant guidance document which explains how to complete this form correctly?*

If you have any questions, please email sustainability@dacorum.gov.uk

Yes I have read and understood.

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* 2. What’s the name of your project/ application?*

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* 3. What are the contact details for the lead applicant?*

Name

Address Line 1

Address Line 2

Town

Postcode

Email address

Phone number

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* 4. What is your position or involvement with the organisation, group or club making this application*

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* 5. Name of organisation, club or group making this application*

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* 6. Address of organisation, club or group making this application*

Address Line 1

Address Line 2

Town

Postcode

Email address

Phone number

Website

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* 7. Is your organisation constituted or non-constituted?*

A constituted group has a governing document such as a constitution, a committee and a bank account, a non-constituted group is an informal or grass roots community group currently without a governing document, committee or bank account but who may wish to become constituted at a later time.

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* 8. If constituted, what type of organisation?*

Registered charity (please provide charity number in details)

Club or other form of association

Company limited by guarantee

Other (please provide details)

Please give further details if required:

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* 9. Brief description about your organisation/ group and its main services or activities?

(maximum 300 words)*

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* 10. How many paid staff members do you have?*

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* 11. How many volunteers do you have involved in service delivery?*

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* 12. Is this a completely new project? (i.e. one that your organisation has never previously undertaken?)

If it is not a new project or is an addition to an existing project, please explain this fully in the project outline below.*

Yes

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* 13. Provide an outline of the project or activity that you are applying for funding for and give details on how you expect your project to contribute to mitigating the Climate and Ecological Emergency? (max 1000 words) *

Note: For practical energy projects and biodiversity projects please also provide separately relevant technical documents to support your application, such as, the specification of the proposed works, feasibility study, technical reports, site plans and maps etc. These should be prepared by a suitably qualified professional where required.

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* 14. Please provide the proposed start and end dates for the project delivery?

Start date:

Date

End date (if applicable):

Date

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* 15. As a borough, we need to reach net-zero carbon emissions as quickly as possible.
Explain how your project relates to our Key Environmental Theme: Energy and Emissions?

- Tell us what actions you will be taking specifically in this area and the outcomes you expect to see.
- Outline how you plan to measure and report on the success of this?

(maximum 500 words)*

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* 16. In the UK, transport is the biggest sector for releasing greenhouse gas emissions.
Explain how your project relates to our Key Environmental Theme: Sustainable Transport?

- Tell us what actions you will be taking specifically in this area and the outcomes you expect to see.
- Outline how you plan to measure and report on the success of this?

(maximum 500 words)*

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* 17. In the past 50 years we have lost a global average of 68% of our wildlife populations.
Explain how your project relates to our Key Environmental Theme: Biodiversity?

- Tell us what actions you will be taking specifically in this area and the outcomes you expect to see.
- Outline how you plan to measure and report on the success of this?

(maximum 500 words)*

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* 18. Living sustainably and ‘Reducing, Reusing and Recycling’ are all key behaviours that can help to mitigate environmental damage.
Explain how your project relates to our Key Environmental Theme: Waste and Consumption?

- Tell us what actions you will be taking specifically in this area and the outcomes you expect to see.
- Outline how you plan to measure and report on the success of this?

(maximum 500 words)*

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* 19. Explain how your project involves the local community and encourages them to ‘think global and act local’?

Outline how your activities will meet our Key Community Benefits; ‘making new connections’, ‘being more active’, ‘learning’ and ‘volunteering’.

- Tell us what actions you will be taking specifically in this area and the outcomes you expect to see; including how many residents you expect to benefit from the project.
- Outline how you plan to measure and report on the success of this?

(maximum 500 words)*

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* 20. What are the long term benefits of this project to Dacorum’s environment and residents and how do you plan to sustain the project’s benefits after completion?

(maximum 500 words)*

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* 21. What evidence do you have that this project is needed?

(maximum 500 words)*

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* 22. Please give details about how you are working in partnership with other organisations or groups to deliver this project?

(maximum 500 words)*

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* 23. What kind of promotional activities will you be undertaking as part of the project and approximately how many people will you aim to reach with these?

(maximum 500 words)*

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* 24. Are any particular permissions and consents required to deliver this project and if so, are these in place?

Please fully explain your answer. Provide details of any relevant legal and liability aspects of the project, such as: land owner consent, child protection (DBS checks), insurance etc. and what provisions are already in place. What permissions, consents etc have yet to be put in place? We do not expect you to have all necessary permissions in place at the time of applying, but this will be required before funding can be awarded.

(maximum 500 words)*

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* 25. Please outline the current financial setup of your organisation/ group: *

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* 26. How will a grant from Dacorum Borough Council support you on your project/ initiative? *

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* 27. Have you received a grant from Dacorum Borough Council in the last five years? *

Yes

If yes, please give details

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* 28. How much money are you applying for from the Green Community Grants Fund?*

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* 29. What is the total cost of your project?*

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* 30. Please upload a budget sheet as either a Word document or PDF, which provides a breakdown of all estimated costs.

If you have issues uploading this document please send to sustainability@dacorum.gov.uk

Please note - you may be required to show a range of quotes for particular costs to show that your project meets value for money.

PDF, DOC, DOCX file types only.

Choose File

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* 31. If the request is less than the total cost, please explain below how you will fund the difference?*

Total contribution from your own resources:

Total raised from fundraising activities:

Total applied for from other funders and additional details:

Any other sources of funding:

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* 32. Please provide details of any 'in-kind' support you have identified to help deliver the project. This might include the number of volunteers involved, the work they will undertake and estimated hours, along with any other in-kind support you have secured (e.g. free professional time/support).*

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* 33. Data Protection Statement (Data Protection Act 1998):
Dacorum Borough Council, will use the information you give in this form, and any supporting evidence you send to process your claim for grant support. The Council may share the information supplied to other council departments and external agencies.

The Council may also check the information provided with other information that we hold. The Council may, as allowed by law, also get information about you from certain third parties, or provide them with information in order to:

- Make sure the information is accurate
- Prevent and detect crime
- Protect public funds

These third parties include government departments, other local authorities and private-sector organisations such as banks and organisations.

Grant applications paperwork is kept in accordance with the Council's retention policy.

Dacorum Borough Council is the data controller for the purposes of the Data Protection Act 1998.

Please agree to acknowledge that you have read and understood this declaration.

Yes, I agree

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* 34. You are required to provide a number of documents alongside your application.
Please email these to sustainability@dacorum.gov.uk with your project name as the subject.

Constituted Groups:

- Constitution or set of rules
- Insurance certificates
- Annual report
- Recent accounts audited or otherwise certified
- Budget forecast
- Recent Bank Statement
- Planning and building regulation consent (if appropriate)
- Three quotes
- Safeguarding Policy including safe recruitment and training
- Equalities Policy or statement

Non-constituted/ Informal/ Grassroots group:

- Letter of endorsement from a local councillor, a local constituted community organisation, or a police community support officer
- Three quotes (if applicable)
- Copy of public liability insurance (if applicable)
- Basic financial information held by your group (if any)

I confirm I have emailed all of the required documents.

Yes, I have sent these documents

100% of survey complete.

Green Community Grant - Application Form

Your Application

Question Title

* 1. Have you read and understood the Green Community Grant guidance document which explains how to complete this form correctly?*If you have any questions, please email sustainability@dacorum.gov.uk

Question Title

* 2. What’s the name of your project/ application?*

Question Title

* 3. What are the contact details for the lead applicant?*

Question Title

* 4. What is your position or involvement with the organisation, group or club making this application*

Question Title

* 5. Name of organisation, club or group making this application*

Question Title

* 6. Address of organisation, club or group making this application*

Question Title

Question Title

* 8. If constituted, what type of organisation?*

Question Title

* 9. Brief description about your organisation/ group and its main services or activities? (maximum 300 words)*

Question Title

* 10. How many paid staff members do you have?*

Question Title

* 11. How many volunteers do you have involved in service delivery?*

Question Title

* 12. Is this a completely new project? (i.e. one that your organisation has never previously undertaken?) If it is not a new project or is an addition to an existing project, please explain this fully in the project outline below.*

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* 14. Please provide the proposed start and end dates for the project delivery?

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* 20. What are the long term benefits of this project to Dacorum’s environment and residents and how do you plan to sustain the project’s benefits after completion? (maximum 500 words)*

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* 21. What evidence do you have that this project is needed? (maximum 500 words)*

Question Title

* 22. Please give details about how you are working in partnership with other organisations or groups to deliver this project? (maximum 500 words)*

Question Title

* 23. What kind of promotional activities will you be undertaking as part of the project and approximately how many people will you aim to reach with these? (maximum 500 words)*

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* 25. Please outline the current financial setup of your organisation/ group: *

Question Title

* 26. How will a grant from Dacorum Borough Council support you on your project/ initiative? *

Question Title

* 27. Have you received a grant from Dacorum Borough Council in the last five years? *

Question Title

* 28. How much money are you applying for from the Green Community Grants Fund?*

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* 29. What is the total cost of your project?*

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* 31. If the request is less than the total cost, please explain below how you will fund the difference?*

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* 1. Have you read and understood the Green Community Grant guidance document which explains how to complete this form correctly?*

If you have any questions, please email sustainability@dacorum.gov.uk

* 9. Brief description about your organisation/ group and its main services or activities?

(maximum 300 words)*

* 12. Is this a completely new project? (i.e. one that your organisation has never previously undertaken?)

If it is not a new project or is an addition to an existing project, please explain this fully in the project outline below.*

* 20. What are the long term benefits of this project to Dacorum’s environment and residents and how do you plan to sustain the project’s benefits after completion?

(maximum 500 words)*

* 21. What evidence do you have that this project is needed?

(maximum 500 words)*

* 22. Please give details about how you are working in partnership with other organisations or groups to deliver this project?

(maximum 500 words)*

* 23. What kind of promotional activities will you be undertaking as part of the project and approximately how many people will you aim to reach with these?

(maximum 500 words)*