UK Shared Prosperity Fund/Rural England Prosperity Fund
Project Application Form Year 3
Contact Details for this Application
We will use the following details for all communication regarding clarification on your application and the progress of the project if you are successful:
Name of Organisation or Business

Your Name 

Your role in the organisation/business

Your telephone number

Your email address

Your postal address

Postal address of the project location, including postcode (if different from above)

Confirmation
1.	I confirm that I have read the Application Guidance Notes and the Sample Application Form and I have the information required to complete this application. You will be able to save this application as you go along and come back to it later.
 Tick here
Section 1: Project Details
2.	Is this a UKSPF application or REPF application? Please tick one
UKSPF
REPF
Project Name for this application (as opposed to any overarching project)

In no more than 20 words, please describe what the project is (this will be explored later in the main intervention details)
See project description section of guidance notes
If this project is linked to a larger or sister scheme please provide the Name and an Overview of the larger/sister scheme, and how any monies granted will be kept separate from the larger/sister project. (No more than 100 words)

Name of project manager/senior responsible person (SRP) for this project. 

Describe their capability of delivering the project. (No more than 100 words) 

Section 2: Main Intervention
3.	Please tick the MAIN intervention you are applying under (ONLY ONE).
UKSPF C&P E2: Community & neighbourhood infrastructure projects
UKSPF C&P E5: Built & landscaped environment to “design out crime”
UKSPF C&P E7: Support for active travel enhancements in local area
UKSPF C&P E8: Campaigns to encourage visits and exploring of local area
UKSPF C&P E9: Impactful volunteering and/or social action projects 
UKSPF C&P E10: Local sports facilities, tournaments, teams & leagues
UKSPF C&P E14: Relevant feasibility studies
REPF 1.1: Capital grant funding for small scale investment in micro and small enterprises in rural areas
REPF 2.1: Capital grant funding for investment and support for digital infrastructure for local community facilities
REPF 2.7: Capital grant funding for rural circular economy projects
4.	Please provide a brief project description showing how it aligns with your chosen intervention. (No more than 150 words)
See main interventions section of guidance notes

5.	With your main intervention in mind, please select at least ONE Output AND at least ONE Outcome (as per Appendix 2 and Appendix 3 of the Guidance Notes) and insert into the Output(s) and Outcome(s) boxes below. For each 
Output/Outcome you select you must also provide an achievable quantifiable value as indicated in the Guidance Notes (i.e. Jobs created by number, the amount of land in square metres, the distance in km, perception increase by % increase).  Your quantifiable values must be achievable by 31 March 2025 at the very latest. Please then also provide any explanatory notes as necessary 
(150 words per box).                                                                                                     
This question will be scored in line with the methodology set in Section 2.3 of the Guidance Notes and will form the basis of any grant agreement. 

Outputs		
outcomes		

Section 3: Additional Interventions
6.	Please state no more than 2 additional interventions and the relevant outputs and outcomes that you feel this project is able to deliver. Please use bullet points to highlight each one. (No more than 200 words) 
See additional interventions and added value section of guidance notes

Section 4: Added Value
7	Referring to the Council Plan’s Strategic Drivers (Appendix 4) and Growing Opportunities Plan themes (Appendix 5), list the deliverables where you feel your Project will add value. Please indicate the Outputs or Outcomes which will align with these documents, including tangible values as much as possible, being careful not to repeat the details already given in the Intervention questions above. Please start each one with a bullet point. (No more than 100 words)
See additional interventions and added value section of guidance notes

Section 5: Funding & Costs
8        What is the amount you are requesting from the UKSPF/REPF Fund towards your project?                   
This question will be scored in line with the methodology set out in Section 2.7 of the Guidance Notes. Please refer also refer to Section 2.7 about VAT and how UKSPF monies cannot fund VAT in most cases.                                               
See funding section guidance notes
9.	Please itemise how you intend to spend the monies requested from the Fund in Q8 (excluding any match funding), splitting Revenue and Capital spending in the two boxes below.            
                                                              
Please detail the Revenue spend. Please give the amount first, then describe	see funding section guidance notes	
Please detail the Capital spend. Please give the amount first, then describe	see funding section guidance notes	
further comments on financial element (50 words maximum)		

10 Please state the total amount (£) of separate match funding monies expected by your organisation to support the delivery of this project and also provide an overview of where these monies are coming from and how they are to contribute to this project.                                                                    
See the funding section of guidance notes
11.	Please note that any fluctuations upwards in costs post award, will be accommodated outside of the funding agreement.                                                     
 Tick here
12.	Please confirm you have the resources to deliver the Project (i.e. grant spending, project completion and outputs and outcomes achievements) by the deadline of 31 March 2025.                                                   
Yes
No
13 Please give details of the resources anticipated for your organisation to deliver 
this Project. (150 words)                                                                     
The UKSPF Fund has set the following spending conditions with awarded funds. Each of the following spend thresholds refers to an individual supplier/contractor.  
Up to £2,500 – direct award,
Up to £25k – three quotes from potential organisations,                                           
£25k to £100k – Formal tender (in compliance with public contracts regulations, process consideration in the Application Guidance Notes)                    

14. Please confirm that you will comply with these requirements and how. (150 words)

See the procurement section for guidance notes

Section 6: Project Delivery Dates
You will now be asked to provide the key delivery dates associated with this Project. Please bear in mind SPF funds will be available early June 2024. All boxes must be completed.
15.	Project Start date. Please specify if already started.

16.	Please state the period within which the project must begin by (month/year) for the project to be fully completed by 31 March 2025.                          

17.	If relevant, Works Start date.

18.	Spend Completion date of SPF/REPF Funds.

This must be by 28/02/25

19.	Date by which all Outputs will be Achieved
This Must be no later than 31/3/25

20.	Date by which all Outcomes will be Achieved
This must be no later than 31/3/25

21.	Further comments re: delivery dates (50 words max)

Section 7 : Financial Information
We reserve the right to disqualify any applicants who are found to present an unsatisfactory financial position. 
If your organisation is a public body, for example, a council (county, parish or town), NHS Trust, fire or police service or state maintained educational establishment, the following checks and documents are not required. 
Please note that charities and limited companies are not generally public bodies.
We will obtain financial and credit check reports on your organisation (whether you are public or private sector) from an external provider of these services.
If your organisation has not submitted an audited Statement of Accounts to Companies House or to the Charity Commission or your accounts are not available on your website, then please could you supply the following  (this will apply mainly to new organisations that have not yet submitted their first year accounts to Companies House or the Charity Commission):
Latest Cashflow Statement
Latest Profit and Loss Account
Latest Balance Sheet
We will be asking for these documents at the end of the form. 
Alternatively, please could you use the link below to supply us with a report on your organisation (please note, this is a free report and may take some days for you to obtain).  Please note we reserve the right to request the documents above if it is felt necessary to consider a more up to date picture of your organisations financial.          www.experian.co.uk/consumer/statutory-report.html
22 Please list any other supplementary documents you may want us to consider in this process. We will be in contact if we require them.

Section 8: Risk
If you have a risk assessment specifically for the carrying out of this Project, we will ask for a copy to be attached at the end of this application form. (Please note, we are not asking for an operational risk assessment for when the project has been completed.) Your risk assessment should score before and after mitigation, along with high, medium or low risk conclusion for each risk identified. 
23. If you do not have a formal risk assessment, please provide a proportionate assessment of risk, based on the size and value of your Project. For example, what are the risks of delay, non-completion, not achieving outputs or outcomes, and the mitigation to reduce these risks. (200 words maximum) (This question will be scored in line with the methodology set in Section 2.12 of the Guidance Notes). You can skip this question if appropriate.

Section 9 : The Legal Stuff
24.	What type of organisation are you?
NHS Trust
Parish/Town Council
Company
Charitable company (limited by guarantee)
Charitable incorporated organisation (CIO)
Community Interest Company
Unincorporated association
Trust
Other (please describe) {Q24.a}
_______________________________________________________________________
25.	Company and/or Charity number

26.	Registered office address (if different from postal address above)

27.	Name of all trustees (if applicable)

28.	Your current level of Public Liability insurance cover (£)

29.	Your current level of Employer Liability insurance cover (£)

30.	Please state any other relevant insurance cover, including the level (£)

31 Please provide details of all public grants received since 1 April 2022. Space for up to 6 grants available. (Grant 1) You are required to fill out one grant at a time.
Date and Amount		
Funding Organisation		
Purpose		
Exemption Applied, if any		

Please provide details of all public grants received since 1 April 2022. (Grant 2)
Date and Amount		
Funding Organisation		
Purpose		
Exemption Applied, if any		

Please provide details of all public grants received since 1 April 2022. (Grant 3)
Date and Amount		
Funding Organisation		
Purpose		
Exemption Applied, if any		

Please provide details of all public grants received since 1 April 2022. (Grant 4)
Date and Amount		
Funding Organisation		
Purpose		
Exemption Applied, if any		

Please provide details of all public grants received since 1 April 2022. (Grant 5)
Date and Amount		
Funding Organisation		
Purpose		
Exemption Applied, if any		

Please provide details of all public grants received since 1 April 2022. (Grant 6)
Date and Amount		
Funding Organisation		
Purpose		
Exemption Applied, if any		

32. Please indicate which signature block is relevant for signing the grant agreement as a deed.
Company limited by shares or guarantee (signature by a director and a director or company secretary) 
Company limited by shares or guarantee (signature by a director and a witness) 
Charitable Incorporated Organisation (signature by two trustees)
Charitable Incorporated Organisation (signature by sole trustee and a witness) 
Unincorporated charity with authority to sign under section 333 Charities Act 2011 
Unincorporated charity without authority to sign under section 333 Charities Act 2011 
Partnership (signature by one partner under a power of attorney) 
Partnership (signature by all partners)
Limited Liability Partnership (signature by two partners) 
Limited Liability Partnership (signature by one partner and a witness)
Parish/Town Council (signature by two parish/town councillors under seal)  Unincorporated association 
There may be other forms of signature block which you wish to use. If this is the case, or you are not sure what the signature block should be, please note that below.

33.	The Council prefers to use DocuSign electronic signing wherever possible for speed and efficiency. It is simple to use and requires no training. All that is needed is a current email address for each signatory. Some signatories may need to have their signature witnessed and this can also be done using DocuSign provided the witness has an email address. Two or more signatories cannot be witnessed by the same person, so each signatory will require their own witness. Please provide full names and email addresses for your signatories (and witnesses, if applicable) to use DocuSign. 

Signatory 1		
Name		
Position		
Email address		

Witness 1 (if needed)		
Name		
Position		
Email address		

Signatory 2		
Name		
Position		
Email address		

Witness 2 (if needed)		
Name		
Position		
Email address		

34.	If you are not able to complete the grant agreement by electronic signature, please tick this box and give a reason. Skip this question if you can.  
•	 Tick here
Why?

35.	If you receive a grant award you will be entering into a binding legal agreement. You may decide to obtain independent legal advice on the grant agreement; however, there will be no negotiation on the terms of the grant agreement and the Council will not accept any changes to the draft grant agreement provided. Please tick to acknowledge this has been brought to your attention.

•	Tick here
36.	If you are signing for an unincorporated association (any organisation that is not a company, charitable incorporated organisation or public body), you will be signing in a personal capacity and will be responsible for your organisation fulfilling the requirements of the grant agreement.
•	Tick here
Section 10: General Declarations
37.	Please confirm you have not been implicated in or convicted of any activities in line with the following.
	YES	No	
Participation in a criminal organisation			
Conviction of corruption or fraud			
Money laundering			
Terrorist financing			

If you have answered yes to any of the above, please provide further information in the box below. The Council reserve the right to eliminate applicant where an adverse position which present risk to the process and the Council itself.

38.	Please confirm you accept we may publish delivery details of your project, along with performance against the outputs and outcomes committed to in this application.  
•	Tick here
39.	Please confirm you accept the Council may share the contents of your application with third party organisations to co-ordinate funding with those organisations or for other relevant purposes 
•	Tick here
40.	Are there any conflicts of interest which could compromise the conduct of the project? 
•	Yes
•	No
If yes, please provide details of any potential conflict of interest, for example, one of your directors, trustees or councillors is a councillor or officer of Stratford-on-Avon District Council or is a relative or close friend of a councillor or officer.

You will not be able to receive any grant until a grant agreement with the Council has been completed. The sample grant agreement can be found at Appendix 9. 

Your Attachments to Us
Please attach a copy of your Data Protection Policy. (Mandatory)

You may attach a timeline document here should you have one to support (but not replace) the dates you have provided. (Optional)

If you have a risk assessment specifically for the carrying out of this Project, please attach here. (Mandatory)

Please attach latest cashflow forecast, if relevant

Please attach latest profit and loss account, if relevant

Please attach latest balance sheet, if relevant

Please attach free Experian Report, if relevant

Thank you for submitting this application. A copy of this completed application will be sent to you for your records, as soon as possible.
NOW PRESS SUBMIT