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Stage 1 Bassetlaw Community Grants Eligibility Form

i. Project Name

Please confirm the legal name of the applicant organisation.

ii. Applicant Organisation

iii. Applicant Contact Telephone Number

iv. Applicant Email Address

v. Applicant Organisations Postal Address

vi. Website address

vii. Charity Registration Number 

viii. Company Registration number

Please tick the relevant boxes to confirm your organisation type. (Unconstituted groups are not eligible for this funding)

ix. Type of Organisation

x. Amount applying for


xi. Will your project be based in Bassetlaw district and focus support for Bassetlaw District residents?

xii. In what area of the Bassetlaw District will your project be based?

xiii. Please write a brief summary of what your project will aim to achieve? 

xiv. Would you welcome additional support from BCVS for your application or project?

Please confirm your project will deliver the outcomes and outputs required from Priority 1 Communities and Place Shared Prosperity Funded (SPF) Projects.

Please note that whilst children or young people may be involved in a community grants project as indirect beneficiaries, and subject to your own inhouse and robust safeguarding and health and safety policies and controls, for the purposes of Bassetlaw Community Grants contracts and reporting,  target numbers relate to adults age 18 and over. 

Please tick YES or NO if your project will be able to deliver these Outputs and Outcomes

How this must be evidenced: Publicity and individual community grant monitoring report

i. Output: Number of local events or activities supported 

How this must be evidenced: Volunteering role descriptions, and copies of completed volunteer application forms

ii. Output: Number of volunteering opportunities supported

How this must be evidenced: Individual community grant reports ad engagement records in format required by BDC

iii. Outcome: Improved engagement numbers 

How this must be evidenced: Volunteer agreements signed

iv. Outcome: Volunteering numbers as a result of support

All applicants to confirm that:

i. The project will be delivered by a constituted organisation that has ability and permission to receive public funds.

Paid for lobbying, entertaining, petitioning or challenging decisions, which means using the Fund to lobby (via an external firm or in-house staff) in order to undertake activities intended to influence or attempt to influence Parliament, government or political activity including the receipt of UKSPF funding; or attempting to influence legislative or regulatory action;
Payments for activities of a party political or exclusively religious nature;
VAT reclaimable from HMRC;
Gifts, or payments for gifts or donations;
Statutory fines, criminal fines or penalties;
Payments for works or activities which the lead local authority, project deliverer, end beneficiary, or any member of their partnership has a statutory duty to undertake, or that are fully funded by other sources;
Contingencies and contingent liabilities
Dividends;
Bad debts, costs resulting from the deferral of payments to creditors, or winding up a company;
Expenses in respect of litigation, unfair dismissal or other compensation;
Costs incurred by individuals in setting up and contributing towards private pension schemes


ii. I confirm that funds will not be spent on any items or activities excluded from UKSPF support as listed below:

www.gov.uk/guidance/uk-shared-prosperity-fund-branding-and-publicity-6

iii. I have read and confirm the project will comply with UK Shared Prosperity Fund: branding and publicity requirements

•	Participation in a criminal organisation
•	Corruption
•	Fraud
•	Terrorist offences or links to terrorist activity
•	Money laundering or terrorist financing
•	Child labour or any form of trafficking human beings

iv. I confirm that within the past 5 years the applicant organisation or any person who has powers of representation, decision or control within the organisation, has not been convicted of any of the following offences listed below:

v. If the organisation or anyone with powers of representation, decision or control has been convicted of any of these offences in the past 5 years, please contact BCVS to discuss 

(If successful, you will be required to submit a copy of a recent bank statement (not more than 3 months old) in the name of the organisation (no transaction details required)

i. The applicant organisation is able to confirm the following:

The organisation has its own bank account, which requires two unrelated people to authorise cheques and make withdrawals. This must be the name of the organisation applying. 


ii. The applicant organisation has at least three unrelated members on its governing body or Board of Directors?

i. Please confirm that the applicant organisation has a Health and Safety Policy that complies with current legislative requirements.

ii. Please confirm that the applicant organisation has a Safeguarding Policy that complies with current legislative requirements.

iii. Please confirm that the applicant organisation has an "Equity and Diversity" Policy or equivalent

iv. Please confirm that the applicant organisation has a "Sustainability" Policy or equivalent

v. Please confirm that the applicant organisation has a Data Protection Policy 

Please confirm that the applicant organisation holds valid Insurance.  Please state your insurance limits and note, at full application stage copies will be required 

i. Employer’s Liability Insurance of £5 million as a minimum


ii. Professional indemnity insurance 


iii. Public Liability Insurance which includes event insurance if an event is to be included in the full application.


I confirm the applicant organisation works to the standards required under RARPA (Recognising and Rewarding Progress and Achievements) as the quality standard used by the UK government to quality assure non-regulated teaching and learning provision? For further information please see:   https://www.ncvo.org.uk/about-us/our-services/quality-standards/#/

Please note, BCVS will provide information sessions on RARPA and quality assurance to support sector capacity building for those organisations not yet ready but that wish to apply for funding in future rounds.  


Quality Assurance 

By completing this form you acknowledge and agree that the data you have provided in this form will be held for a minimum of six years and used by project partners listed below to consider your eligibility and involvement in the project. Personal data shall be retained in accordance with the General Data Protection (UK GDPR) and other applicable legislation.

To enable project partners to comply with their obligations and funding requirements for Shared Prosperity Fund Projects, we are required to share some or all of the information you have provided on this form with our project partners including Bassetlaw District Council and third-party organisations appointed by partners to undertake audit and evaluation for the purposes of checking eligibility, compliance with Regulations, and audit purposes. Please see our Privacy Notice www.bcvs.org.uk/privacypolicy

Use of data

I give permission on behalf of the applicant organisation to share the contents of stage one and stage two applications for this project with National Lottery Community Fund Officers. This is to enable lottery staff to identify whether any lottery funding programmes could provide support for this proposal. 