COMMUNITY AND SOCIAL DEVELOPMENT

COMMUNITY GRANTS SCHEME APPLICATION FORM 2015

NOTE: Closing Date 28th November 2014
FOR OFFICE USE ONLY
Reference Number:Administrative Area:Dublin City Council Officer:Date Received:

Informal Adult Education:or

Community:-

GROUP /ORGANISATION NAME:

ALL APPLICATIONS ARE TO BE RETURNED TO:

Community and Social Development
Block 3, Floor 1
Civic Offices, Wood Quay.
Dublin 8
By 5pm 28th November, 2014
CLOSING DATE WILL BE STRICTLY ADHERED TO.

Please note that additional information in support of your application can be included.
Please read the Terms and Conditions on page 2.
Please sign DECLARATION on page 7.

Dublin City Council Community Grants Scheme

Dublin City Council operates a community grants scheme in order to support community participation and involvement. Under
the scheme community and voluntary groups may apply for grants for activities which benefit the local community. Applications
must relate to at least one key priority area in order to be eligible for consideration.

Key Priority Areas

Community Development
Social inclusion
Integration
Local area issues
Informal adult education
TERMS AND CONDITIONS

Dublin City Council under the Community Grants Scheme will support community
activities promoted by community and voluntary groups subject to available resources.
We may not support sporting groups/organisations or provide funding for the
employment of staff.
Activity must benefit the local community and relate to at least one key priority.
The information supplied by the applicant group /organisation must be accurate and
complete.
Misinformation may lead to disqualification and/or the repayment of any grant made.
All information provided in respect of the application for a grant will be held
electronically and may be made available to other Dublin City Council Departments as
appropriate. Dublin City Council will publish a list of all grants awarded on its website.
The Freedom of Information Act applies to all records held by Dublin City Council. (The
application must be signed by the Chairperson, Secretary or Treasurer of the
organisation making the submission).
It is the responsibility of each organisation to ensure that it has proper procedures and
policies in place including appropriate insurance to support the proposed activity.
If the proposed activity includes children or young people under 18, each
group/organisation must have in place a child protection policy including a vetting
procedure.
Applications must be on the 2015 form.
Successful applicants must submit a report on the project funded if requested by
Dublin City Council.
Evidence of expenditure, receipts /invoices must be retained and provided to Dublin
City Council if requested.
Dublin City Councils contribution must be publicly acknowledged in all materials
associated with the purpose of the grant.
Generally no third party or intermediary applications will be considered.
Late applications will not be considered.
Applications by post should use the correct value of postage stamps and allow
sufficient time to ensure delivery not later than the closing date of 5pm Friday 28th
November 2014 Claims that any application form has been lost or delayed in the post
will not be considered, unless applicants have a Post Office Certificate of Posting in
support of such claims.
Breaches of the terms and conditions of the grants scheme may result in sanctions
including disbarment from future grant applications.
Some grants awarded may be conditional on a further agreement between Dublin City
Council and the proposed grantee on the application of the grant.

All questions on this form must be answered. Please write your answers
clearly in block letters.
SECTION 1 CONTACT DETAILS
Name of Group / Organisation

Address
Postal District
Contact Name
Role in Group / Organisation
Telephone Number
E-mail
Website
Please delete YES or NO as appropriate to the following questions.
Have you received funding under a Dublin City Council Community Grants scheme within the last
three years?
YES / NO
Have you received funding from any other Dublin City Council Department within the last three
years?
YES / NO
If YES please give details:Dublin City Council Department.
Funding Stream / Scheme
If YES, have you submitted your Bank Account Details to Dublin City Council?
Please give details of your group /organisation which appears on the Bank Account
Group / Organisation Name
Address
Contact Name

YES / NO

SECTION 2 - GROUP/ ORGANISATION DETAILS

Purpose of group / organisation?
______________________________________________________________________________________
_______________________________________________________________________________________
Year established: _______________________________________________________________________
Please provide a brief organisational description of your group / organisation
e.g. committee structure, meeting schedule etc.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Has your Organisation / Group registered with the Dublin City Public Participation Network (PPN)?
YES / NO
Do you receive funding from any other organisation?

YES / NO

If YES please give details below.

Name of Organisation:

Amount Received:
Date Received:

Is your organisation affiliated or connected to any relevant local regional or national body? YES/NO
If Yes please give details below.
Name of Organisation(s):
_______________________________________________________________________________________
How does your organisation link in with other organisations in your area or at city level?
_______________________________________________________________________________________
_______________________________________________________________________________________
Charitable Status Number (if applicable): ___________________________________________________

SECTION 3 - PURPOSE OF GRANT

Please highlight/circle which key priority area/s this grant application relates to:
Community Development Social Inclusion
Local Area Issues

Integration

Informal Adult Education

Please highlight/circle which categories are most appropriate to the activity this grant application
relates to:
Recreation

Play

Children/young people

Educational
Older Persons

Environmental

Festival/Event

People with disabilities

People of working age

What is the purpose of the grant? (Outline details of the activity).

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Who is the target group that will benefit from this activity? Please give approximate numbers.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
If activity is for under18s is a child protection policy including garda vetting in place?
YES / NO
If the answer to the above question was No why not?
____________________________________________________________________________________
___________________________________________________________________________________
Where will this activity take place? (Please indicate if activity is at local area or city wide level)
____________________________________________________________________________________
Start Date of activity__________________

End Date activity__________________

SECTION 4 - FUNDING
Please highlight / circle which Band your application falls under.
0.00- 500.00,

500.00- 1,000.00,

over 1,000.00

Please give the exact amount being applied for under the DCC Community Grants Scheme?

What is the overall total cost of this activity?

Please provide a detailed breakdown of the costs of the activity

Item

Cost

Where will you source any shortfall of funding?

Source

Amount

SECTION 5
DECLARATION

Position held in organisation:

________________________________

I declare that the information given in this form is correct. I confirm I have read and fully
understand the Terms and Conditions of the Community & Voluntary Grants scheme. (See page 2
of application form).
I confirm that this grant application is submitted in acceptance and compliance with the Terms and
Conditions.

BLOCK CAPITALS:
Signed (on behalf of group /
organisation):
Position held in group / organisation:

Date: