Dún Laoghaire-Rathdown County Council. Universal Grant Scheme. Arts Access Grants. CRM No: Date Received: Internal Use only

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Dún Laoghaire-Rathdown County Council Universal Grant Scheme 2018 Arts Access Grants CRM No: Date Received: Internal Use only

Section 1 Organisation Applicant Details To be completed by applicants applying for an Arts Access Grant Organisation/Group Details: Name of Youth Project/Community Group: Name of Organisation (if different): (Bank details need to match this name) Address for correspondence: Brief Description of Organisation/ Group: Contact Details for this project: Name: Main Phone Number: Mobile Phone Number: Email Address: Organisation Website (if applicable): Social Media (if applicable): Facebook Address: Twitter Address: Other Social media: Electoral Ward: Blackrock Dundrum Dún Laoghaire Glencullen Sandyford Killiney Shankill Stillorgan Type of Organisation: Youth Service/Club Older Persons Group Have you the appropriate policies in place regarding: Child Protection Yes No People with Disabilities Yes No Other Policies (please specify) 1

Section 1 Organisation Applicant Details, continued Membership Details: Total Number of Members: Age Breakdown of Members: Please specify the number of members in each category: 0 9 years 10 14 years 15 18 years 19 21 years 22 54 years 55 + years Committee / Volunteers / Organiser Details: Number of paid staff: Number of voluntary staff: Part time: Part time: Full time: Full time: Membership fees - Cost per member: Financial Status: Incorporated Yes No Unincorporated Yes No Trust Yes No Other (please specify) Tax / Vat Registered Yes No Tax / Vat Registered number Charity Registered Yes No Registered Charity Number 2

Section 2 Arts Access Grants Please read below guidelines to see if your application will qualify for consideration for funding. Please note- if you are applying for an Arts Grant for Professional Artists please use the separate Arts Grant Application form. Arts Access (Maximum 3,000) Arts Access grants are available to provide financial assistance to targeted areas of the community in need of greater opportunities for artistic expression. Specifically this grant is aimed at Youth Service Providers and Older Persons Groups only in order to give these areas of the local community access to the Arts. The applicant/s must include 1) details of the proposed project. 2) a detailed budget including supporting materials. 3) if the costs of any materials are being applied for you must provide detailed quotes for the amount being requested. 4) If an artist/facilitator is part of the project plan a detailed cv must be provided. 4) details of how this project will develop the participants artistic skill. Arts Grants Eligibility: Applications must be for activities taking place in Dún Laoghaire- Rathdown County. Dún Laoghaire-Rathdown Arts Office seeks to support financially sustainable artistic ventures. In regards to applications from organisations only not for profit organisations will be considered. Grants will not cover building programmes, third party grants, or assistance to cover loans or deficits, projects which could be undertaken on a commercial basis, charity fundraising events or the hire fee of Council premises. 3

Arts Access Grant Section: Describe below the arts project for which you are seeking funding. This must include: - Details of the artform (e.g. dance, music, visual arts) that will be used - The dates the project will take place - Where the project will be held - The number of participants - The age range of the participants Name of facilitator/s: You must submit a detailed CV and/or biography of the facilitator/s you wish to use for this project. This must include information regarding their qualifications, relevant experience, contact information and references. Please outline how this project will develop the artistic skill of the participants: 4

Budget & Project Funding: State the amount of money you are applying for: State what additional funds (if any) have been secured and from whom: State what other funding applications (if any) have been made and when you expect to receive notification of the outcome of these applications: Please include as much detail as possible in this section. This is an important part of our assessment of your application. You may also attach a detailed budget as one of your supplementary materials. Budget breakdown Facilitator x hrs x weeks Equipment purchase/ Hire Venue Hire Materials Transport Income Other (Please specify) Total cost of project Amount 5

Check list for Arts Access Grant Application: Signed and completed application form including project description and detailed budget breakdown CV and/or biography of facilitator/s Quotes to back up cost of materials Quotes to back up cost of equipment or hire of equipment Signed the Declaration form on page 7 Supplementary Materials (may include previous projects, photographs, CDs etc). Please note applications and supplementary materials will not be returned. Dún Laoghaire-Rathdown is committed to the fair payment of artists. If applicable please state the rates of pay you offer artists: If you have received funding from dlr in the past have you submitted a report on the activity funded (if no please state why not): Yes No Would you like to receive the Arts Office e-bulletin which gives information on upcoming events and opportunities in the County? Yes No How did you find out about this funding opportunity? 6

Declaration: I declare that the information supplied in this proposal is accurate and complete. I understand that all information provided in respect of the Grant Application will be held electronically and may be made available to other Dún Laoghaire-Rathdown County Council Departments as appropriate. It should be noted that the Freedom of Information Act applies to all records held by Dún Laoghaire-Rathdown County Council. Name (Printed): Signature: Position: Date: 7

Please ensure you have read the Grant Scheme Guidelines, which set out the terms and conditions for awarding and payment in full. A copy of the guidelines are available from the Council s website, www.dlrcoco.ie, under Grant schemes or can be requested by phone from the Grant Schemes Section on 01 204 7966 or by email to grantschemes@dlrcoco.ie The closing date for submissions is Friday 13 th October 2017 No late applications will be accepted Please return applications to: Or by post to: grantschemes@dlrcoco.ie 2018 Grant Schemes Corporate, Communications and Governance Department Dún Laoghaire-Rathdown County Council County Hall Marine Road Dún Laoghaire Co. Dublin All queries should be directed to the Grant Schemes section by email or phone: Email: grantschemes@dlrcoco.ie Phone: (01) 204 7966 Please ensure you read through the following application in detail as any incomplete applications will be returned. Only one Grant per application form please Multiple applications will be accepted but may not all be awarded. Please submit a separate application for each grant you wish to be considered for. 8