Final Application Form

AWARDS FOR SPORT

Application Form

Awards for Sport

Internal use only Reference Number:

_____________________________________________

Checked in by:

_____________________________________________

Date received:

_____________________________________________

Decision due:

_____________________________________________

Decision:

YES

NO

Assessment completed by: _____________________________________________

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PRELIMINARY CHECKLIST

Awards for Sport

Before you complete the application it is imperative that you answer the questions below honestly:

Q1. Do you have a bank account in the organisation’s name? YES



NO



Q2. Do you have a constitution or a set of RULES? YES



NO



Q3. Do you have a safeguarding children and VULNERABLE adults POLICY? YES



NO



Q4. CAN YOU PROVIDE A COPY OF YOUR MOST RECENT ANNUAL ACCOUNTS IF YOU ARE SUCCESSFUL? YES



NO



Q5. CAN YOU PROVIDE BANK / BUILDING SOCIETY STATEMENTS IF YOU ARE SUCCESSFUL? YES



NO



Q6. CAN YOU PROVIDE QUOTES FOR THE EQUIPMENT? YES



NO



If your answer to any of these is NO then DO NOT proceed in completing this application.

If you answer YES to all these questions then we will request that these details are submitted before we make an award, subject to your application being successful.

If we find that the documents are not present then any potential award will be deemed as invalid. Sample documents can be downloaded from www.sportni.net/awardsforsport

Please complete this application form in CAPITALS.

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1. YOUR ORGANISATION Q1.

Your Organisation

Name of your organisation, as it appears on your governing document or set of rules.

Address of your organisation (this may be where the organisation is based or where activities take place) including full postcode. Address

We will only fund: governing bodies of sport, sports clubs and community/voluntary organisations provided they complete this form in full. (Page 8 of the Guidance Notes)

City/Town County Telephone

Postcode

Website Address

Email Address



Which type of organisation are you? (Please tick) Governing Body

Sports Club

Community/Voluntary Organisation

Which sport most relates to your organisation i.e. Basketball, Football, Gaelic Football, Hurling, Rugby, Swimming, etc. (If you are involved in various sports please specify your activities as multi-sport)?

When did your organisation start? (Month/Date)

If you are a branch or related to a larger organisation, please provide details

How many people are involved in your senior committee?

Please give a summary of the main activities of your organisation

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This will give us a better understanding of what your organisation does and how your project fits in with your day-to-day work.

2. MAIN CONTACT Q2.

Awards for Sport

Main Contact

This must be someone from your group who can talk about your project and can be contacted during normal office hours. If possible we would prefer that this person is not the chief executive or chairperson as we require this person to complete the senior contact section. Title

First Name

Surname

Note that the Sport Northern Ireland will liaise directly with the main contact throughout the various stages of the application process. It is therefore their responsibility to ensure that the application is complete and any additional documents can be provided if successful.

Position held in organisation

Home address including postcode Address City/Town County

Postcode

Date of Birth

Email Address

Telephone (Day)

Telephone (Evening)

Contact address (if different from the address above) where all correspondence will be sent. Address City/Town County

Postcode

Please specify if you have any communication needs i.e. Textphone, Sign Language or different language requirements

Remember that it will take up to eight weeks to hear a decision about the success of your application. You should allow at least three months between the date you apply and the planned project date. When you plan your project ask yourself, “How will my project meet the programme priorities?” We want projects that: • Increase participation, especially among under-represented groups – ethnic minorities, women and girls, young children and older people. • Improve sporting performance (Page 5 of the Guidance Notes)

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3. Your Project Q3.

What is the name of your project?

Q4.

When do you expect your project to happen?

Start date (day/month/year)

End date (day/month/year)

Q5. Please give a summary of what activities will take place if your organisation receives an award.

Q6. Tell us the number of people you expect to benefit from your project. 19-49

0-18

Q7.

50+

How many beneficiaries will be in each of the below categories?

Females

People with disabilities

Ethnic minorities

Q8. Criteria 1: Contribution to programme priorities. Tell us how your project will meet one, or both, of the Awards for Sport aims. Is your project tailored towards? 1. Increasing Participation 2. Improving Sporting performance 3. Both Sport Northern Ireland understands that most projects will meet one of the criteria only. Applications will be assessed on merit and we would encourage applicants only to complete the sections that are relevant to their projects. Only complete the two sections if you can clearly demonstrate how you will meet the criteria set out in the Guidance Notes. 06

Please use the space provided to give us as much relevant detail about your project. Page 1113 of the Guidance Notes show how you should develop your application and the criteria that is required.

Awards for Sport

Tell us how your project will meet one, or both, of the Awards for Sport aims.

(a) Increased participation in sport and physical recreation, especially among under-represented groups.

(b)

Note that most projects will meet only one of the criteria. You do not need to complete both answers to question eight unless your project genuinely meets both criteria.

Increased number of athletes with improved sporting performance.

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Q9. Criteria 2: Describe how your project will be effectively planned and organised. For example, what actions will you take to ensure that your project will attract the desired participants, what partners (if any) will be involved in the project and what role will they play, how will the project be managed and implemented effectively, and what outcomes are expected and how will you monitor these?

Q10. Criteria 3: How have you identified the need for your project?

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Awards for Sport

Q11.

 riteria 4: Describe how your project is innovative. For example, how is the C project different from the normal activities of your organisation, how are you targeting new groups, participants and activities, or how are you taking a new approach to address an existing problem?

Q12. Have you received an Awards for All/Awards for Sport grant before:

Yes

No

If yes please specify the date in which it was awarded.

Please provide details of the Award:

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4. PROJECT COST Q13. How much is your project going to cost? Project Budget

£

Q 13.1 What contributions are you able to make to the project? £ Q 13.2 Please specify the source of this funding i.e. is it self-funded, partnership funded, sponsorship funded or funded by other means?

Q 13.3 Has it been secured? Yes

No

Q 13.4 Has your organisation got any financial reserves? Yes

No

If yes please specify the amount and what they are being held for. £

Q 14.  How much do you need from Awards for Sport? Requested From Sport Northern Ireland

£

Please specify the equipment you require from Sport Northern Ireland, providing us with a breakdown of how the funds will be spent. Note that if successful Sport Northern Ireland will require that quotes are submitted to justify these costs. Please list ITEM AND COST ITEM

Cost £



10

Total

Awards for Sport

Q 14.1. Where will this equipment be stored?

Q 14.1.2 Who owns this storage facility?

Please note that you need to have an access agreement for your storage facility to ensure that you can access your equipment over the two year period.

Q14.2 Who will be responsible for maintaining the equipment? What is their current role?

Q14.3. Which category of membership within your club will be the main users of the equipment?

Q 15. Please tell us if your organisation has received a grant within the last two years. Funder

Reference Number

Awarded

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5. YOUR REFEREE Q16. Independent Referee

This must be from the relevant group listed in the Guidance Notes – page 15

Title

First Name

Surname

Date of Birth

Employer

Occupation

Job Title

Email

Membership of a professional body

Membership number

Business address, including full postcode Address City/Town County

Postcode

Telephone (Day)

Telephone (Evening)

Please specify if you have any communication needs i.e. Textphone, Sign Language or different language requirements

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Page 15 of the Guidance Notes gives information on who your referee should be.

6. SENIOR/ALTERNATIVE CONTACT

Awards for Sport

Q17. Senior contact and signatory contact

This must be from the relevant group listed in the Guidance Notes – page 11.

Title

First Name

Surname This must NOT be the same person named in Question 2.

Date of Birth

Position in group

This may be the Chairperson, Secretary, Treasurer, Chief Executive or Director (Page 11 of the Guidance Notes).

Email

Business address, including full postcode Address City/Town County

Postcode

Telephone (Day)

Telephone (Evening)

Address for correspondence, including full postcode if different from above Address City/Town County

Postcode

Please specify if you have any communication needs i.e. Textphone, Sign Language or different language requirements

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7. ALTERNATIVE CONTACTS Q18. Provide us with at least three alternative contacts that are linked directly to the club: Name

14

Address

Telephone

We require additional contacts in the event that the main contact or senior contact are unattainable.

8. PROJECT BENEFICIARIES

Awards for Sport

This section of the Application Form will be used for programme monitoring purposes only and not to assess your application. We want to know who will benefit most from your project. This information will help us identify the types of projects that apply to us for funding and receive an award.

Q19. Where do most of the beneficiaries live?

Name of town, city or village

Council area

Postcode of project location

Q20. Is your project directed at or of particular relevance to, any of the following groups of people? You can tick up to three categories People living in rural areas



People living in urban areas

Gay/Lesbian/Bisexual



People living in low income

Carers



People with dependents

Long-term health concerns



Unemployed people

Disabled people



Older people

Younger people



Transgendered

Other



None

Q21. Is your project directed at, or of particular relevance to, people of a specific gender? Male

Female

Both

Q22. Is your project directed at, or of particular relevance to, people of a specific age? 0-18

19-49

50+

15

Q23. Is your project directed at or of particular relevance to, people of a specific community? Catholic

Protestant

Other

Both Catholic and Protestant If other, please specify.

Q24. Which ethnic background is your project directed at or of particular relevance to? White



Irish Traveller

Chinese



Pakistani

Bangladesh



Indian

Black African



Black Caribbean

Ethnic (other)



Black (other)

Q25. Please record the nationality of the participants who will benefit: British



Irish

Chinese



French

Latvian



Lithuanian

Polish



Portuguese

Other



If other, please specify.

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DECLARATION

Awards for Sport

Data Protection Act We will use the information you give us on the application form during assessment and for the life of any grant we award you to administer and analyse grants and for our own research. We may give copies of this information to individuals and organisations we consult when assessing applications, when monitoring grants and evaluating the way our funding programmes work and the effect they have. These organisations may include accountants, external evaluators and other organisations or groups involved in delivering the project. We may also share information with other Lottery distributors, government departments, organisations providing matched funding and other organisations and individuals with a legitimate interest in Lottery applications and grants, or for the prevention or detection of fraud. We might use the data you provide for our own research. We recognise the need to maintain the confidentiality of vulnerable groups and their details will not be made public in any way, except as required by law. Freedom of Information Act The Freedom of Information Act 2000 gives members of the public the right to request any information that we hold. This includes information received from third parties, such as, although not limited to, grant applicants, grant holders, contractors and people making a complaint. If information is requested under the Freedom of Information Act we will release it, subject to exemptions; although we may consult with you first. If you think that information you are providing may be exempt from release if requested, you should let us know when you apply. Declaration We will take this form as confirmation that you understand our obligations under the Data Protection Act 1998 and the Freedom of Information Act 2000 and that you accept that we will not be liable for any loss or damage to you pursuant to our fulfillment of our obligations under the relevant law.

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Key Points to Note: If your project is successful then you must submit the following: • Declaration terms and conditions – signed by main contact and senior contact; • Bank and Building Society confirmation – completed by your bank and stamped; • R  eferee – you must have this completed by the referee as listed on your application – we will check this by contacting the person and their organisation; • Set of Governing Documents/Constitution; • A  copy of your annual accounts covering the last two years – SIGNED by senior contact; • A  copy of your bank or building society account statement which covers three month period; (not more than three months old) • A copy of a Safeguarding Children and Vulnerable Adults policy; and • A copy of any quotes to support your application. For all costs we will request copies of quotations to verify the amount requested. In the event that the quotes do not support the requested amount we may amend or withdraw our offer. Please ensure that all quotations are kept.

Main contacts signature I confirm that to the best of my knowledge and belief, all the information in this application form is true and correct and that the relevant information has been submitted. I understand that you may ask for additional information at any stage of the application process.

Signature of main contact

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Date

Awards for Sport

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Sport Northern Ireland House of Sport 2a Upper Malone Road Belfast BT9 5LA Telephone: (028) 9038 3232 Email:

[email protected]

Website:

www.sportni.net

This document is available in other accessible formats on request, and online at www.sportni.net

Awards for Sport