Application form for City of York Council Sport and Active Leisure (SAL) Small Grants Fund The SAL Small Grants Fund aims to support voluntary organisations in increasing the number of active members or to support the delivery of a quality experience to participants. Grants must be used to fulfill one of the following criteria: Funding Criteria • • Increase the number of new participants Support the delivery of a quality sporting or activity experience The grant can be used to support coach or volunteer education, sports equipment, venue hire or to support the delivery of new programmes of activity. The Sport and Active Leisure team are keen to see an increase in sport participation for the following groups; Women, those over the age of 50, disabled people and Black Asian and Minority Ethnic groups. We will prioritise any applications that will increase participation within these particular groups. There will be two funding rounds available. Round 1 – 1st September – 31st October 2015 awarded in November 2015 Round 2 – 1st January – 28th February 2016 awarded in March 2016 Applications are limited to £500 in total, with only one application accepted from an organisation in each financial year. ORGANISATION NAME ADDRESS NAME OF CONTACT PERSON CONTACT ADDRESS IF DIFFERENT FROM ABOVE Sport and Active Leisure Small Grants Fund Application Page 1 CONTACT NUMBER AND/OR EMAIL ADDRESS POSITION IN ORGANISATION TOTAL PROJECT COST: £ AMOUNT REQUESTED FROM CITY OF YORK COUNCIL: £ Please tell us about the service or activity that you would like City of York Council to fund. Please identify what the funding will be specifically used for and how it will meet the funding criteria. Sport and Active Leisure Small Grants Fund Application Page 2 Please identify how many people will benefit from the funding? Male Female *BAME Disabled Number of participants Number of coaches/volunteers (Training) Total *Black, Asian, Minority Ethnic Please enclose any financial information you may have. If you are applying to renew/purchase equipment you must enclose a quote. DECLARATION: The information given on this from is to the best of my knowledge complete and correct. 1. Signed: Print Name Date Position on Management Committee 2. Signed: Print Name Date Position on Management Committee Standards and Good Practice Please tick which of the following documents and policies your organisation has. Please enclose copies with the application. Constitution Equal Opportunities Policy Health & Safety Policy First Aid Certificates Insurance Certificates DBS Clearance * Clubmark accredited or NGB equivalent Working towards Clubmark/NGB Accreditation Sport and Active Leisure Small Grants Fund Application Page 3 * If you or any of your groups work with children or vulnerable adults you must have clearance from the Disclosure and Barring Service (DBS) - formally Criminal Records Bureau (CRB). If you need any help with this please contact Dan Stanley on 553377. Please return this application form to Dan Stanley. Email: daniel.stanley@york.gov.uk Post: City of York Council Sport & Active Leisure West Offices Station Rise York YO1 6GA For Office Use Only: Amount to be Awarded: Code to be used: Name of Officer (please print) Sport and Active Leisure Small Grants Fund Application Page 4