Main contact (Full Name) *
Position held in organisation *
Are the contact details for this person different to the main organisations details (to be entered below)? * No Yes
Number of paid staff in organisation *
Number of volunteers in organisation *
Aims or purpose of your organisation *
(Please include a brief history; number of members/clients and/or groups that benefit from your activities)

Project Details:

What is the title of your project? *
(Please give your project a working title)
When will your project start? *
(DD/MM/YYYY – applications can take up to 12 weeks to process and your project must NOT start before this)
When will your project end? *
(DD/MM/YYYY – Please remember; your project must be completed within 12 months)
Which corporate aim(s) of Basildon Council will your project or initiative fulfill? *
Please explain how you feel this project or initiative will fulfill the corporate aim(s) selected *

Full description of the project or initiative *
(Include key dates and milestones, along with any consultation that has been done)
Details of any necessary permissions, consents and/or licenses sought or received *
(if applicable)
Can you confirm that your organisations activity is inclusive of any person regardless of age, sex, disability, sexual orientation, marital status, race, gender reassignment, religion or belief? * No Yes

What will the "lasting benefit" of the project be? *
How will your project/initiative create opportunities for volunteers within the Borough? *
(This may include existing volunteers within the organisation, as long as there are new opportunities for them to develop)

Project Funding:

How much funding are you requesting (£)*
(Please ensure the amount requested is the same in the budget sheet you attach below)
Do you already have any match/part funding for the project? * No Yes
How are you ensuring value for money in the project or initiative? *
Please complete the Budget sheet, found here and upload it below: *
(Applications received without the supplied Budget Sheet completed, will not be considered for funding)
Please upload a recent bank statement within the last 3 months: *
(Your application cannot be assessed without this:)

Final Questions:

Are you working with children, young people or adults with care and support needs? * No Yes
Which area(s) of the Basildon Borough will your initiative benefit?
Which local client(s) group would your grant mostly benefit?
Where did you hear about this grant?

Declaration:

Please confirm you have read and accept the following? *   I confirm