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APPLICATION FOR ASSISTANCE UNDER THE EU LEADER II PROGRAMME

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APPLICATION FOR ASSISTANCE UNDER THE EU LEADER II PROGRAMME Powered By Docstoc
					The Community Support Scheme is financed through the Salmon Hardship Fund under the National Development Plan. It is administered by the Department of Communications, Energy and Natural Resources and the Department of Community, Rural and Gaeltacht Affairs _________________________________________________________________________________________________________________________________

FILE NO. ____________

PROGRAMME:

COMMUNITY SUPPORT SCHEME

Group Name:

________________________________________________

Address:

________________________________________________

________________________________________________

Tel:

_______________________________ Fax: _________________________

Email: _______________________________ Website: ______________________

The Community Support Scheme is a scheme to support the development of additional economic opportunities in communities affected by the closure of the drift-net fishery. The focus of the scheme will primarily be communities where drift-net fishing has been a well established activity and where its withdrawal demonstrably impacts on their economic and social fabric. Those eligible under this scheme would especially include those formerly involved in the drift-netting sector, or, alternatively, where a promoter proposes to employ a significant number of people formerly engaged in drift netting.

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The Community Support Scheme is financed through the Salmon Hardship Fund under the National Development Plan. It is administered by the Department of Communications, Energy and Natural Resources and the Department of Community, Rural and Gaeltacht Affairs _________________________________________________________________________________________________________________________________

FILE NO. _________ APPLICATION FORM FOR GRANT ASSISTANCE (Individual/Group/Company) All Applicants to complete Section 1, 2 and 3. Please Complete Section 1.A (Individual), 1.B (Community/Group) or 1.C (Enterprise) as appropriate. SECTION 1: APPLICANT DETAILS … GENERAL 1. Applicants Name: Address: Tel. No: Mobile No: Classification of Applicant (Please tick appropriate box): Individual Co-operative Public Body Limited Company 3. Proposal Completed by: Address: 4. Applicants background and experience (including details of all relevant qualifications) _____________________________________________________________________________________ _____________________________________________________________________________________ 5. 6. Name / Address of Bank A/C Name and Address of Accountant (if available) SECTION 1 A: INDIVIDUALS 1. 2. PPS Number: Name of Boat / Fishing Vessel: Name of Owner / Operator: Did you receive compensation under the Salmon Hardship Fund Community Group Email:

2.

Other (please specify)_____________

3.

4.

Yes

No

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The Community Support Scheme is financed through the Salmon Hardship Fund under the National Development Plan. It is administered by the Department of Communications, Energy and Natural Resources and the Department of Community, Rural and Gaeltacht Affairs _________________________________________________________________________________________________________________________________

5.

Your Role / Job Description:

6. 7.

Period of Employment on Boat / Fishing Vessel: Current Employment Details:

SECTION 1 B : COMMUNITY / CO-OP / OTHER GROUPS 1. Officers of the Group: Name:______________________ Position/role:__________________________ Name:______________________ Position/role:__________________________ Name: _____________________ Position/role:__________________________ Name:______________________ Position/role:__________________________ 2. Date of establishment / brief history : Membership information:

3.

Number of active members:________ Membership Criteria: _______________________________________________

4.

Aims and objectives of group:

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The Community Support Scheme is financed through the Salmon Hardship Fund under the National Development Plan. It is administered by the Department of Communications, Energy and Natural Resources and the Department of Community, Rural and Gaeltacht Affairs _________________________________________________________________________________________________________________________________

1.

SECTION 1 C: PROCESSORS / OTHER ENTERPRISES Number of people employed currently in your business : Full Time Part Time Male Female

Seasonal

2.

What impact has the closure of the drift-net fishery had on employment levels in your business? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

3.

What impact will the proposed project have on sustaining existing or creating new employment? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

4.

What is the timeframe for proposed new job creation? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

1.

SECTION 2: PROPOSED PROJECT How have you or your community been affected by the closure of the drift-net fishery? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

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The Community Support Scheme is financed through the Salmon Hardship Fund under the National Development Plan. It is administered by the Department of Communications, Energy and Natural Resources and the Department of Community, Rural and Gaeltacht Affairs _________________________________________________________________________________________________________________________________

2.

Brief Description of Proposed Project ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________

3. 4.

Project Location

_____________________________________________________________ No

Have you undertaken market research / other research appropriate to the project? Yes If Yes, please outline your findings

_______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ If No, how have you identified the need for the proposed project? _______________________________________________________________________________ _______________________________________________________________________________ 5. Will the proposed project generate a new demand or divert demand from an existing service / facility? ____________________________________________________________________________________ ____________________________________________________________________________________

6.

What is the nature of assistance sought? (please tick as appropriate) Capital Marketing Project Schedule: What is the proposed start date? Number of phases? Completion date? Technical Training ______________________________________________________ ______________________________________________________ ______________________________________________________

7.

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The Community Support Scheme is financed through the Salmon Hardship Fund under the National Development Plan. It is administered by the Department of Communications, Energy and Natural Resources and the Department of Community, Rural and Gaeltacht Affairs _________________________________________________________________________________________________________________________________

1.

SECTION 3: STATUTORY APPROVALS/PERMISSION & SOURCES OF FINANCE Do you have the following? Yes No N/A a) Ownership/satisfactory lease on project base/site? b) Planning permission for proposed development? c) Quotations to substantiate projected costs? d) Tax Clearance Certificate? e) Other Statutory approvals required? Yes Yes Yes Yes No No No No N/A……. N/A…….. N/A

Where ‘No’, please state how these requirements will be met and outline the basis for any exemptions that apply: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ €

2.

3.

What is the total cost of the project and how do you intend to finance it? *Community Support Scheme grant rates vary depending on the nature of assistance sought and the applicant type How do you intend to use the Community Support Scheme grant?

Own Funds Loans CSS* Grant Other Total

%

4.

Have you sought/received grant aid from other sources in respect of this project? Yes No N/A If Yes, please provide details:

Source(s): ___________________________________________________________________ Outcome: ___________________________________________________________________ Date(s): ____________________________________________________________________

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The Community Support Scheme is financed through the Salmon Hardship Fund under the National Development Plan. It is administered by the Department of Communications, Energy and Natural Resources and the Department of Community, Rural and Gaeltacht Affairs _________________________________________________________________________________________________________________________________

SECTION 4: FINANCIAL DATA A Business Plan and comprehensive financial data must accompany all applications seeking grant assistance for commercial or capital investment purposes. All applications should be supported by quotations for each element of expenditure. Please attach the following with your application as appropriate : Business Plan, Outline of Project Costs, Income and Expenditure Projections (3 years), Cash Flow Projections (3 years), Historical Financial Data.

SECTION 5: CHECKLIST Please confirm the availability of each of the following items and enclose as appropriate. Grant approval will not be made without consideration of all appropriate documentation. Detailed Project Costings Planning Permission & Conditions Evidence of matching finance Other Statutory Approvals Fire Safety Certificate Relevant Insurance Letter of support from former licence holder Historical Financial Data Projected Financial Data VAT Registration Number/Exemption Regulatory Body Approval Tax Clearance Certificate/PPS Number

I confirm that I have read and understand all sections of this document and declare that the information and documentation supplied in this application is true and accurate. I will supply any additional information required for evaluation purposes. Signature of Applicant(s): ____________________________________ Date: _____________________

Applicant(s) Name: (capital letters)

____________________________________

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