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TRAINING AND MENTORING SUPPORTS FOR SOCIAL ENTERPRISES PILOT APPLICATION FORM SEPTEMBER 2019 CLOSING DATE AND TIME FOR APPLICATIONS IS 30 TH SEPTEMBER 2019 @3PM.

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Page 1:  · Web viewEach time you enter (or delete) a value in any of the numeric cells in the Budget Table below, please ensure that you tab across or click into a different numeric cell

TRAINING AND MENTORING SUPPORTS FOR SOCIAL ENTERPRISES PILOT

APPLICATION FORMSEPTEMBER 2019

CLOSING DATE AND TIME FOR APPLICATIONS IS 30TH SEPTEMBER 2019 @3PM.

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Section OneApplication Form – Useful Information

Before you fill in your application: Save a copy of the application form to your own computer as a

Word Document - please do not PDF the final completed form. The questions in the application form have a maximum character

limit imposed for your response and this is illustrated by the size of the textbox for each question i.e. the text box size indicates the maximum amount of information that you can include in your response. If necessary you can include further information at Q26. Please note: only the information that is visible within a textbox will be taken into account when appraising your application.

Read the application guidelines. These guidelines describe who can apply, what actions and costs are eligible and how we will appraise your application.

The guidelines are available on the following websites: Pobal Website: How to Apply to DAF Department of Rural and Community Development Website

Any QuestionsIf you have any questions in relation to “Training and Mentoring Supports for Social Enterprises”, please contact a member of our team.

E-mail: [email protected]: 01 5117222

Useful InformationOur website has further information and advice on how to make a successful application. Planning an Applicationhttps://www.pobal.ie/app/uploads/2019/04/Pobal-Brochure-1-Planning-an-Application-web.pdf

Writing an Applicationhttps://www.pobal.ie/app/uploads/2019/04/Pobal-Brochure-2-Writing-an-Application-web.pdf

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Section TwoYour organisation and contact details

1. What is the full legal name of your organisation? This is the name shown on your governing documents. Click or tap here to enter text.

2. Does your organisation have a different business name that you use for your day to day work? If yes, please provide your business name.Click or tap here to enter text.

3. Please provide the following reference numbers or registration numbers for your organisation.

Company Registration Number (Issued by the Companies Office)

Click or tap here to enter text.

Industrial Provident Society Number (if applicable)

Click or tap here to enter text.

Charity Registration Number(Issued by the Charities Regulator)

Click or tap here to enter text.

CHY Number (Issued by the Revenue Commissioner)

Click or tap here to enter text.

Tax Registration Number (TRN) Click or tap here to enter text.

Tax Clearance Access Number (TCAN) Click or tap here to enter text.

4. Please select your organisation type

Choose an item.

5. What is the address of your organisation?

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Address Street1

Street2

Street3

Town/City Town/City

County Select County

EIRCODE(To find your Eircode go to: www.eircode.ie )

Eircode

Phone Number (Landline)

Telephone

E-mail Email

Website Website

6. Your ContactsWe need some personal information for two different people in your organisation involved in your application.

a) A main contact i.e. the person we can contact on behalf of your organisation in relation to this application.

b) Chairperson or Chief Executive Officer’s contact details i.e. the person legally responsible and accountable for this application and any subsequent grant agreements (contract).

Main ContactName First Name & Last Name

Role/Job Title Role/Job Title

E-mail Email

Telephone Landline

Mobile

Chairperson or Chief Executive OfficerName First Name & Last Name

Role/Job Title Role/Job Title

E-mail Email

Telephone Landline

Mobile

7. Your governance arrangements

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How many people are on your board? Highlight any relevant expertise or experience of your board relative to this application to support social enterprises.Click or tap here to enter text.

How often does your board meet each year?Click or tap here to enter text.

Has your board any sub-committees? If yes, please provide the name of each sub-committee, their main function and how often each sub-committee reports to the board. Click or tap here to enter text.

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Has your organisation adopted a governance code? If yes please provide details. If your organisation is in the process of adopting a governance code, please provide details of the code and progress to date. Click or tap here to enter text.

Provide a summary of your organisation’s financial controls, policies and procedures.

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Click or tap here to enter text.

8. About your organisation

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Provide a concise overview of your organisations current main aim and key activities over the past 5 years.Click or tap here to enter text.

To be eligible for funding applicant organisations must have a minimum of two years’ experience in delivering training, mentoring or supports to social enterprises directly or on a contract basis.

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Please outline your organisations’ relevant experience and expertise in delivering supports, mentoring and or training to social enterprises.Click or tap here to enter text.

Provide a summary of relevant Exchequer, EU or philanthropic funding that your organisation has been awarded and directly managed over the previous 3 years.

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YearAwarded

Funder Programme Amount Awarded

Year Funder Programme Amount

Year Funder Programme Amount

Year Funder Programme Amount

Year Funder Programme Amount

Year Funder Programme Amount

9. PartnershipsIf your organisation is planning to deliver your project with a partner or partners please provide the following information:Partner(s) Legal Names and their Legal Status. For example, Corporation Limited by Guarantee, Not for Profit, Statutory Body etc.Click or tap here to enter text.

Partner(s) Role(s) in the implementation and delivery of the project.

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Click or tap here to enter text.

10.RiskOutline any key risks you have identified in relation to delivery of your project, including any mitigations to reduce the risks identified. Click or tap here to enter text.

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Section ThreeYour Project

11. Provide a title for your project

Click or tap here to enter text.

12. What is the proposed start date and end date for your project?

Note: The earliest start date for your project will be 1st December 2019 and the latest end date will be the 30 th June 2020 . Your project can start or finish any time between these dates.

Start Date Click to enter a date not earlier than 01/12/2019.

End Date Click to enter a date not later than 30/06/2020.

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13. Describe your project. In your description please explain how the project will provide supports, mentoring and training to social enterprises.

Click or tap here to enter text.

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14. Describe how the project meets the aims and objectives of this grant programme? Refer to the applicant guidelines for the programmes aims and objectives and key criteria in your response.

Click or tap here to enter text.

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15. Describe how your project is in line with the new National Social Enterprise Policy for Ireland 2019-2022.

Click or tap here to enter text.

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16. Clearly indicate how your actions are additional to any current supports, mentoring and training which is currently available. You must ensure that your project actions are not duplicating current provisions or services.

Click or tap here to enter text.

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17.Outline the key actions, activities and timelines for your project.

Action 1Insert a brief description of this action:Click or tap here to enter text.

List the key activities that will be undertaken to ensure this action is

delivered within the project timeframes

Date by which each activity will be delivered

Who is responsible for delivering this

action?

1 Click or tap here to enter text. Click here Click or tap here to enter text.

2 Click or tap here to enter text. Click here Click or tap here to enter text.

3 Click or tap here to enter text. Click here Click or tap here to enter text.

4 Click or tap here to enter text. Click here Click or tap here to enter text.

5 Click or tap here to enter text. Click here Click or tap here to enter text.

6 Click or tap here to enter text. Click here Click or tap here to enter text.

Action 2Insert a brief description of this action:Click or tap here to enter text.

List the key activities that will be undertaken to ensure this action is

delivered within the project timeframes

Date by which each activity will

be delivered

Who is responsible for delivering this

action?

1 Click or tap here to enter text. Click here Click or tap here to enter text.

2 Click or tap here to enter text. Click here Click or tap here to enter text.

3 Click or tap here to enter text. Click here Click or tap here to enter text.

4 Click or tap here to enter text. Click here Click or tap here to enter text.

5 Click or tap here to enter text. Click here Click or tap here to enter text.

6 Click or tap here to enter text. Click here Click or tap here to enter text.

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Action 3Insert a brief description of this action:Click or tap here to enter text.

List the key activities that will be undertaken to ensure this action is

delivered within the project timeframes

Date by which each activity will

be delivered

Who is responsible for delivering this

action?

1 Click or tap here to enter text. Click here Click or tap here to enter text.

2 Click or tap here to enter text. Click here Click or tap here to enter text.

3 Click or tap here to enter text. Click here Click or tap here to enter text.

4 Click or tap here to enter text. Click here Click or tap here to enter text.

5 Click or tap here to enter text. Click here Click or tap here to enter text.

6 Click or tap here to enter text. Click here Click or tap here to enter text.

Action 4Insert a brief description of this action:Click or tap here to enter text.

List the key activities that will be undertaken to ensure this action is

delivered within the project timeframes

Date by which each activity will

be delivered

Who is responsible for delivering this

action?

1 Click or tap here to enter text. Click here Click or tap here to enter text.

2 Click or tap here to enter text. Click here Click or tap here to enter text.

3 Click or tap here to enter text. Click here Click or tap here to enter text.

4 Click or tap here to enter text. Click here Click or tap here to enter text.

5 Click or tap here to enter text. Click here Click or tap here to enter text.

6 Click or tap here to enter text. Click here Click or tap here to enter text.

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Action 5Insert a brief description of this action:Click or tap here to enter text.

List the key activities that will be undertaken to ensure this action is

delivered within the project timeframes

Date by which each activity will

be delivered

Who is responsible for delivering this

action?

1 Click or tap here to enter text. Click here Click or tap here to enter text.

2 Click or tap here to enter text. Click here Click or tap here to enter text.

3 Click or tap here to enter text. Click here Click or tap here to enter text.

4 Click or tap here to enter text. Click here Click or tap here to enter text.

5 Click or tap here to enter text. Click here Click or tap here to enter text.

6 Click or tap here to enter text. Click here Click or tap here to enter text.

Action 6Insert a brief description of this action:Click or tap here to enter text.

List the key activities that will be undertaken to ensure this action is

delivered within the project timeframes

Date by which each activity will

be delivered

Who is responsible for delivering this

action?

1 Click or tap here to enter text. Click here Click or tap here to enter text.

2 Click or tap here to enter text. Click here Click or tap here to enter text.

3 Click or tap here to enter text. Click here Click or tap here to enter text.

4 Click or tap here to enter text. Click here Click or tap here to enter text.

5 Click or tap here to enter text. Click here Click or tap here to enter text.

6 Click or tap here to enter text. Click here Click or tap here to enter text.

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18. Need for the project Explain what specific need(s) for social enterprises your project will address.Click or tap here to enter text.

How will your project meet the needs identified?Click or tap here to enter text.

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Provide a description of the types of social enterprises that your project will support.Click or tap here to enter text.

How are social enterprises involved in the design of your project? Please provide details. Click or tap here to enter text.

19.Outputs and Outcomes

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List the anticipated outputs for your project. Please refer to the outputs outlined in the application guidelines. Note: If your application is successful you will be required to report on progress against these targets.

Output Target(If applicable)

1 Click here to enter text. Click here

2 Click here to enter text. Click here

3 Click here to enter text. Click here

4 Click here to enter text. Click here

5 Click here to enter text. Click here

6 Click here to enter text. Click here

7 Click here to enter text. Click here

8 Click here to enter text. Click here

9 Click here to enter text. Click here

10 Click here to enter text. Click here

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List any anticipated outcomes for your project. Please refer to the outcomes outlined in the application guidelines.

Outcomes1 Click here to enter text.

2 Click here to enter text.

3 Click here to enter text.

4 Click here to enter text.

Click or tap here to enter text.

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Click or tap here to enter text.

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Section FourFinances

21. Is your organisation registered for VAT? Choose an item.If Yes, the amount of grant awarded will be net of VAT. The figures entered in this section of the application form must be net of VAT.If your organisation is not registered for VAT i.e. your organisation cannot claim the VAT back from Revenue, the figures entered in this section of the application form are the costs including VAT.

22. What is the total cost of your project? Enter whole number only–no decimals.

Click or tap here to enter text.

23. What is the grant amount you are seeking from this programme?Enter whole number only–no decimals.

Click or tap here to enter text.

24. If the total cost is greater than the grant amount requested, please provide an explanation on how these additional costs will be met by your organisation. Please note that you are required to upload evidence of this funding with this application to your account on DAF Portal 2.

Click or tap here to enter text.

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25. Please complete the budget table below. Ensure that you read the application guidelines in advance. The application guidelines provides you with information on eligible and ineligible costs and the information on the level of detail we require. Information Note: This table has automatic totals for each section of the Project Budget. Insert Whole Numbers only i.e. do not include cents/decimal places. Each time you enter (or delete) a value in any of the numeric cells in the

Budget Table below, please ensure that you tab across or click into a different numeric cell in this same table below to refresh the total. This is particularly important in the last cell of each table.

Project BudgetProject Cost Dec 2019-

Jun 2020Cost (€)

Refer to the eligible costs outlined in the application guidelines.Provide a detailed explanation and justification for each cost applied for.

Direct Project CostsInsert Project Cost Title       Enter details of the cost; basis and justification

Insert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justification

Insert Project Cost Title       Enter details of the cost; basis and justificationInsert Project Cost Title       Enter details of the cost; basis and justification

Subtotal Direct Project Costs

0

Direct Employment Costs (if applicable)

Insert Direct Employment Cost Title

      Enter details of the cost; basis and justification

Insert Direct Employment Cost Title

      Enter details of the cost; basis and justification

Insert Direct Employment       Enter details of the cost; basis and justification

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Cost TitleInsert Direct Employment Cost Title

      Enter details of the cost; basis and justification

Insert Direct Employment Cost Title

      Enter details of the cost; basis and justification

Insert Direct Employment Cost Title

      Enter details of the cost; basis and justification

Insert Direct Employment Cost Title

      Enter details of the cost; basis and justification

Insert Direct Employment Cost Title

      Enter details of the cost; basis and justification

     Subtotal Direct Employment Costs

0

Total Project Costs

0

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Section FiveAdditional Information

26. Any other relevant information to support your application?

You may include any further information to support your application in the following two pages. Please clearly indicate which question in the application form the information corresponds to.

Click or tap here to enter text.

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Click or tap here to enter text.

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Checklist for ApplicantsApplicants must ensure that the following information is uploaded with a completed application form to the DAF Portal 2 :

A copy of the organisation’s Governing Documents (e.g. Memorandum and Articles of Association). Note: This is not required if your organisation currently has a grant agreement (contract) with Pobal and you have not changed your Governing Documents recently.

A signed copy of the organisation’s 2018 Annual Financial Statements. Note: This is not required if your organisation currently has a grant agreement (contract) with Pobal and you have already submitted these to Pobal for 2018.

Vat Not Recoverable Template. (if applicable) Note: Refer to the application guidelines for more information.

Evidence of Co-Funding. (if applicable) Note: This evidence is only required if the total cost of your project is greater than the grant amount requested.

Job Description(s). (if applicable) Note: This is required for each salary cost which has been included in the Project Budget at Question 25.

The completed application form and all supporting documentation must be submitted via the DAF Portal 2* b y Monday 30 th September 2019 at 3pm as application forms or supporting documents will not be accepted after this time.

*DAF Portal 2 will be available on the Pobal Website from Friday 20th

September 2019.

Applicants who have additional queries that are not covered in the applicant guidelines or technical guide should contact Pobal for further clarification using the details noted below:

Pobal Online Support Team

Email: [email protected] Phone Support: 01 511 7222

Opening Hours: 8am – 6pm (Monday to Friday)

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Section SixDeclarations and Submission

1. Disclosure Under the Freedom of Information Under the Freedom of Information Act 2014, the information in this document and its attachments may be released on request to third parties.

If you believe that any of the information in this document is sensitive and should not be disclosed to a third party, you must identify the sensitive information and provide the reason(s) for its sensitivity.

You will be consulted about the sensitive information before any decision is made to release the information to a third party.

If you do not identify any of the information supplied in this document and supporting documentation as being sensitive you are acknowledging that any, or all of the information supplied, may be released in response to a Freedom of Information request.

Please outline the sensitive information and the reason(s) for the sensitivity in the text box below.  

Click or tap here to enter text.

2. Data Protection Pobal is responsible for the administration and delivery of the Dormant

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Accounts Fund Training and Mentoring Supports for Social Enterprises (DAF TMSSE) on behalf of the Department of Rural and Community Development (DRCD). We are committed to protecting and respecting your privacy. We respect your trust in us. To fulfil our regulatory and statutory obligations, we will collect some personal information from you, such as your contact information and details of your board members and staffing resources. We may share your information with the DRCD, as joint data controller of DAF TMSSE.

We use information about you to:

• process a grant application• carry out our obligations arising from our contract for administrating (DAF TMSSE)• notify you of any changes relevant to your grant agreement (contract)• send you communications relevant to your grant agreement (contract)• collect and analyse programme data and demographic information to enhance service delivery and support government policy• seek your views or comments on the supports we provide. In compliance with GDPR, all application forms and personal information submitted to Pobal will be kept only for purposes relating to the administration of the funding. We will hold your personal information on our systems for as long as is necessary for the relevant activity, or for as long as is set out in any relevant contract you hold with us. This is subject to legislation and regulatory rules we must follow as set out by the DRCD. Pobal takes our security responsibilities seriously, employing the most appropriate administrative, physical and technical measures to safeguard your personal data, and regularly review these measures.   Personal data should not be disclosed within this application form for any reason incompatible with the purpose for which funding is sought. Furthermore, any individual whose personal data is submitted within this form must be informed of the use of their personal data. By submitting this application form you are confirming individuals whose personal data is disclosed have been clearly informed of this purpose and have been informed of their rights under data protection legislation.

For more information on your privacy rights, please see our full Privacy Statement on our website.

3. Application Submission

Please read carefully:

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By submitting the application, the Board of Directors/Management Board declare that the information provided in relation to the organisation described in this application is true and complete to the best of their knowledge and belief.

The Board of Directors/Management Board acknowledges that any funds awarded must be used for the purpose stated and not used to replace existing funding. The Board also understands that information supplied in, or accompanying, this application may be made available on request under the Freedom of Information Acts 2014.

The Board accepts, as a condition of the award of a grant, that it involves no commitment to any other grants from The Department of Rural and Community Development (DRCD) or Pobal. The Board are agreeable to having the project monitored by Pobal and DRCD and to allow access to premises and records, as necessary, for that purpose.

The Board of Directors/Management Board also accepts that Pobal may contact other Funder Organisations or Government Departments to discuss this application and previous funding awarded, as part of the appraisal process.

It will be a condition of any application for funding under the terms and conditions of the Dormant Accounts Fund Training and Mentoring Supports for Social Enterprises that:

i. The DRCD and Pobal shall not be liable to the applicant or any other party in respect of any loss, damage or costs of any nature arising directly or indirectly from:

a) the application or the subject matter of the application;b) the rejection for any reason of any application.

ii. The DRCD, its servants or agents shall not at any time in any circumstances be held responsible or liable in relation to any matter whatsoever arising in connection with the development, planning, construction, operation, management and/or administration of individual projects.

By submitting this application the Board of Directors/Management Board acknowledges that they have read, understood and accepted the above points.

Enter the name of person submitting the application:

Click or tap here to enter text.

Position on the board: Choose an item.Choose an item.