community support fund application form, july 2012

July 2012 Our reference number:

Community Support Fund: Application Form

Thank you for considering applying to the Community Support Fund.

To assist you in completing this form we have created some guidance notes. Accessible versions of this form and the guidance notes are also available. All of these can be found on our website: http://odi.dwp.gov.uk/communitysupportfund

Please read the guidance notes before you complete this application form. They contain useful information about the Community Support Fund, including by when your application should be submitted for consideration in each funding round.

If you have any questions about your application please contact us by emailing [email protected].

Your contact details

Name of your organisation:

Name and position in the organisation of the person completing this form:

Postal address:

Telephone number:

Mobile phone number:

Email address:

Organisation website:

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mailto:[email protected]

http://odi.dwp.gov.uk/communitysupportfund


1. About your application

1.1 Is this a partnership/joint application?Yes (see questions below) / No (proceed to Section 2)

Please note: Applications to the Community Support Fund from organisations working in collaboration – that can develop and demonstrate effective partnership working, especially with disabled people and their organisations – will be particularly encouraged. See Section 9.2 – Area 3 of the Guidance Notes.

1.2 Are you the lead contact/organisation?Yes / No Please note only the lead organisation can make the application

1.3 List the name(s) of the organisation(s) who you are working with you in this project/activity

1.3 Is/Are the organisation(s) you are working in partnership with one or more of the following:

A Disabled People’s User-Led Organisation (DPULO)

Yes / No

A Voluntary and Community Sector Organisation

Yes / No

A

Yes / No

A Social Enterprise

Yes / No

A Community Interest

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Yes / No

A Non-Profit Organisation

Yes / No

An employee- or member-owned organisation

Yes / No

Other (please specify

Yes / No

Working in collaboration with another organisation (Please provide details

Yes / No

2. About the lead organisation

2.1 Are you:

A DPULO

Yes / No

A Voluntary and Community Sector Organisation

Yes / No

A Charity

Yes / No

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A Social Enterprise

Yes / No

A Community Interest Company

Yes / No

A Non-Profit

Yes / No

Other (please specify

Yes / No

3. Your location

3.1 Are you: In one or more local community/communities affected by a

Remploy Factory closure?

(A list of geographical areas is included in the Guidance Notes.) Yes / No

Please state which area(s):

3.2 If not, can you demonstrate a clear understanding of the needs of the local community/communities affected by the Remploy Factory closure?

Please supply supporting evidence.

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4. Funding

4.1a Can you confirm that your organisation has not received funding for this particular project/activity from UK Government or the Devolved Administrations

Yes/ No

4.1b Can you confirm that this project/activity is over and above what your organisation is delivering with any funding from central government or the Devolved Administrations

Yes/ No

4.1c Have you received or applied for funding from either the Community Support Fund or Strengthening DPULOs Programme Facilitation Fund1 before?

Yes / No

If yes, please provide your reference number(s):

4.2 Please provide confirmation that you are applying for the funding as the lead officer for the organisation and have regularly audited accounts that could be made available on request

Yes / No

4.3 Please confirm you can receive payment of any award made through the Community Support Fund

Yes / No

4.4 Please provide confirmation that you have read and understand your obligations with regards to de minimis awards received, detailed in Schedule 3

Yes / No

1 Question only applicable to England-only organisations pre-July 2012

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4.5 What is the total amount of de minimis aid your organisation has already been granted during the previous two fiscal years and the current fiscal year?

4.6 Please confirm that the amount of grant applied for will not result in the total amount of de minimis aid received during the previous two fiscal years and the current fiscal year exceeding €200,000

Yes / No

4.7 Please confirm that you will retain details of this grant and produce it on any request by the UK public authorities or the European Commission

Yes / No

5. About your proposed activity / project

5.1 What is the name of your proposed activity / project?

5.2 How much you are applying for?

5.3 Please summarise your proposed activity / project (150 words max)

5.4 Please use the Project Plan template contained at Schedule 1 to tell us your proposed key activities, outputs and associated timescales

5.5 For each activity and associated output(s) please use the Budget Breakdown template contained at Schedule 2 to tell us what money you require

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6. Delivering the outcomes of the Community Support Fund

6 How will your proposed activity / project make a positive difference to the lives of disabled people affected by the Remploy Factory closure?

To do so, it should cover one or both of the following bullets:

Support individuals to become actively involved in their local communities

or/and

Support individuals to make the move from sheltered to mainstream employment. (100 words)

(See Sections 2 and 3 of the Guidance notes for more information about the the aim and objectives of the Community Support Fund)

7. Developing Communities and working in partnership

Important note: you must clearly demonstrate how disabled people affected by the Remploy Factory closure have been involved in developing the proposed activity / project. See Area 2 of the Essential Criteria in the Guidance Notes.

7.1 What individuals or groups have you engaged with to develop your proposed activity / project? Please list all of them here.For example:

Ex-Remploy employees? Remploy factory? A DPULO Ambassador/National Lead? Other local organisations? Local Authorities? Local employers?

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Anyone else?

7.2 How have you engaged these individuals / groups to develop your proposed activity / project? (100 words)

7.3 How will you be taking forward the partnership working to meet the objectives of this project/activity? (100 words)

7.4 How will your activity / project develop, or strengthen links within the local community? (100 words)

7.5 If you haven’t discussed this activity / project with anyone else, please tell us why (100 words)

Please enclose any relevant letters of support with your application as this will strengthen your application.

8. Capturing impact, sustaining involvement and sharing learning

8.1 How will you capture and understand the impact the proposed project / activity has to ensure it makes a positive difference to the lives of people affected by the a Remploy Factory closure? (100 words)

8.2 Where possible, we would like to see the impact of the Community Support Fund extend beyond the funding period. How will you try to sustain the involvement of people affected by the Remploy Factory closure in your work beyond the time of the formal project? (100 words) Please note: This question is for information only. It will not be marked.

8.3 How will you capture the wider learning from your activity / project for the benefit of DPULOs and VCS organisations more generally, especially in working with disabled people? (100 words) Please note: This question is for information only. It will not be marked.

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9.Confirmation

I confirm that if my application is successful I am happy for details of my award and my organisations name and any partner names to be published on the ODI website and used in press releases to publicise the fund.

Yes / No

This application form has been completed and authorised by:

Signature:

Print name:

Position:

Organisation:

Date:

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10. Sending us your Community Support Fund application

Your completed application form for the Community Support Fund should include all of the following:

This application form Letters of support A completed project plan (Schedule 1) A completed budget breakdown (Schedule 2)

Once you have completed your Community Support Fund application form, please send it to the Making a Difference team at: Email: [email protected] Post: Office for Disability Issues, Ground Floor, Caxton House,

6-12 Tothill Street, London SW1H 9NA

You will receive confirmation from us that we have received your Community Support Fund application within 7-14 working days.

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mailto:[email protected]


Community Support Fund Application: Schedule 1 – Your project plan


Please complete this project plan template to tell us more about your proposed activity / project in more detail (to answer Question 5.4 of the application form).

Activity Output Timescale1. 2. 3. 4. 5. Please add further rows as necessary

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Community Support Fund Application: Schedule 2 – Budget breakdown


Please provide a breakdown of the costs you think will be covered by any funding awarded (to answer Question 5.5 of the application form).

Item of expenditure

Activity number this relates to (from your project plan)

Budget (UK sterling)

1. 2. 3. 4. 5. Please add further rows as necessary

Total:

This budget breakdown has been completed and authorised by:

Signature:

Print name:

Position:

Organisation:

Date:

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Community Support Fund Application: Schedule 3 – State Aid requirements

What is State aid?

Where a public body provides financial support to an organisation engaged in commercial and economic activity, it is necessary to consider whether such support constitutes State aid.State aid applies if: Aid is granted by a Member State or through its resources; It favours certain undertakings or the production of certain

goods It distorts threatens to distort competition ; and It affects trade between Member States.

Key questions to consider if a payment will fall within the state aid regulations:

1. Is the support provided granted by the State?This includes all public and private bodies controlled by the state to distribute public funds. For example, Lottery, tax exemptions, grants, subsidies.2. Does the support confer a selective advantage to an

undertaking?A benefit which is granted for free or on favorable (non-commercial) terms to some selected organisations (but not others), could be state aid. Definitions:Advantage: An advantage can take the form of direct payment of state resources in the form of grants and subsidies as well as indirect benefits that affect the public budget such as tax breaks, rate rebates, low interest loans, sale of public land below market value and the provision of services for free or at below-market rates. Selectivity: Support that targets particular businesses, regions or types of firm e.g. SMEs or particular sectors and not others is selective.Organisations - do not have to be profit-making as long as the activity carried out is one which, in principle, has commercial competitors. This can include voluntary and non-profit-making public or public authorities when they are engaged in economic activity. Charities, universities, research institutions, voluntary entities, social enterprises and public sector bodies will be considered when they are engaged in economic activity. Economic activity: Offering goods or services on a given market

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and which could, at least in principle, be carried out by private actors in order to make profits.3. Does the support distort or have the potential to distort

competition?If the funding has the potential to strengthen the position of the organisation relative to other competitors then this criteria is likely to be met. The potential to distort competition does not need to be substantial or significant, and this criterion can apply to relatively small amounts of financial support and firms with little market share. 4. Does the support affect trade between Member States?Commission's interpretation of this is broad - it is sufficient that a product or service is tradeable between member states, even if the recipient of support does not itself export to other EU markets. This test is not met only in very limited circumstances.

If all four questions are met State Aid applies.

Additional information about de minimis aid previously received

You are being considered for assistance under the De minimis Regulation (Regulation 1998/2006). This may allow an enterprise to receive up to €200,000 de minimis aid over any period of three fiscal years.

To establish whether you are eligible to receive de minimis aid you must declare the full amount of de minimis aid which you have already been granted during the previous two fiscal years and the current fiscal year.

Any assistance you may have received from a public body could potentially be de minimis aid. This might include assistance received from central, regional, or devolved governments, as well as from other agencies or local councils.

You should have received a letter informing you if you were given assistance under the de minimis regulation. If you are unsure as to whether or not any public assistance you have received is de minimis aid, please contact the granting body to clarify.

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Please provide information about any public assistance under €200,000 you have received in the last three years in question 6 of the application form.

The following is not a comprehensive list of all possible forms of aid. However, it should provide an indication of some of the most common forms of de minimis aid which you may have been awarded over the past three years.

Forms of possible aid: State grants; Interest rate relief; Tax relief; Tax credits; State guarantees or holdings; State provision of goods or services on preferential terms; Direct subsidies; Tax exemptions; Preferential interest rates; Guarantees of loans on especially favourable terms; Acquisition of land or buildings either gratuitously or on

favourable terms; Provision of goods and services on preferential terms; Indemnities against operating losses; Reimbursement of costs in the event of success; State guarantees, whether direct or indirect, to credit operations

preferential re-discount rates; Dividend guarantees; Preferential public ordering; Reduction of, or exemption from, charges or taxes, including

accelerated depreciation and the reduction of social contributions;

Deferred collection of fiscal or social contributions; Assistance financed by special levies; Capital transfers; Certain State holdings in the capital of undertakings.

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community support fund application form, july 2012

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