Sports Access Grants

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Dún Laoghaire-Rathdown County Council Universal Grant Scheme 2018 Round 2 Sports Access Grants GROUP NAME: ACTIVITY: CRM No: Date Received: Internal Use only

Section 1 Organisation Applicant Details To be completed by ALL Applicants applying for a Sports Access Grants Applicant Details: Name: Address: Contact Details: Main Phone Number: Mobile Phone Number: Email Address: Website: Social Media: Facebook Address: Twitter Address: Other Social media: Electoral Ward: Type of Applicant: Arts Centre/Organisation Business Association Community Group Heritage Sports Group Tidy Towns Group Residents Association Number of households: Other (please specify) Have you the appropriate policies in place regarding: Child Protection Yes No People with Disabilities Yes No Other Policies (please specify): 1

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 Sports Grants To be completed by any group applying for a Sports Acess Grants. Please make sure that you have read the grant guidelines to see if your application will qualify for consideration for funding. Please note Sports Access Grants do not fund Sport Equipment or Sports Events. Groups seeking funding for Sport Equipment should apply for a Community Equipment Grant through the Community Grants Application. Sports Access Grant Guidelines Up to a maximum of 1,500 can be awarded under Sports Access. The Sports access grant stream aims to provide financial assistance to sport and community groups and organisations to pursue opportunities to increase participation and to provide opportunities for the local community to participate in physical activity. The project should be used to access sporting activity that people in your area wish to participate in, but for various reasons, find it difficult to do so or the opportunity may never have presented itself before. Deliver equitable provision of a diverse range of sport and recreation opportunities Increase participation Improve standards of programme Only one application should be lodged to this funding stream per funding round. Assistance will be purely financial in nature Maximum amount 1,500 Please note that submitting an application for this grant stream does not guarantee funding as this is a competitive process. The application will be assessed by a panel of three impartial Council Officers The delegation level for decisions will be the full Council 3

3. Sports Access Grant Application: Name of event: Brief description of event/activity: Course Venue: Target Group: Number of Participants: Age breakdown of participants Male Female 0 10 years 11 14 years 15 18 years 18 25 years 25+ years Profile of Participants: Aims And Objectives of Project: Start Date: / / Completion Date: / / How will grant funds be used? 4

Details of Supervision Arrangements where necessary: Budget & Project Funding: State the amount of money you are applying for: 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. Type of Expenditure Tutor or Coach x hrs x weeks Equipment purchase/ Hire* Venue Hire Materials* Transport Other (Please specify)* Total Expenditure Amount *Please include as detailed breakdown as possible, for example copies of quotes for purchase/hire included in supplementary material. Contribution by members of group: Please detail what other sources of funding you have for this project, such as membership fees, other grants, etc. Source of funding: 2018 DLR Grant Application Total Income Amount Total Expected Income: Total Estimated Expenditure: Total Cost of Project: 5

Check list for Sports Access Grant Application: Complete Pages 1 to 2 of the Grant Application Ticked the Sports Access box Completed application form Signed Declaration Included at least two quotes for each component of the project that funding is being requested for Included a copy of a public liability insurance certificate Provide a copy of your Memorandum / Articles / Constitution Included a copy of tutor/coaches qualifications Any additional information you feel supports your application Please note, applications and supplementary materials will not be returned. 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 20 th April 2018 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