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									        Ballymoney Borough Council
    Central & Leisure Services Directorate

     Good Relations Grant Aid Programme
              Application Form


When you have completed this application form, please return it to:

Claire Crawford
Good Relations Officer
Ballymoney Town Hall
1 Townhead Street
Ballymoney
Co. Antrim
BT53 6BE

If you would like to discuss the application form, please phone the Good
Relations Officer on 0282 766 0233

You can get more information from the ‘Good Relations’ section of our
website at www.ballymoney.gov.uk




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     Good Relations Grant Aid Programme

     Application Form

     This form will be used to decide whether your organisation will receive funding from our
     Good Relations Grant Aid Programme.

     Please read the attached guidance notes before you fill in this application form. Should you
     have any queries, please feel free to contact our Good Relations Officer on 028 2766 0233
     OR email claire.crawford@ballymoney.gov.uk. Please try and answer all questions fully, to
     avoid your application being delayed.

     Please remember to attach a copy of your group’s constitution and bank statement to the
     application form, and retain a copy for your own records.


1)   Contact Details

     Your name
      Title (Mr, Mrs)               First Name                     Surname



     Your position within the organisation
      Position




2)   Your organisation’s details

      Name
      Address




      Postcode                                           Phone Number
                                                         (daytime)
      Any other phone                                    Fax number
      numbers
      Email address



3)   Details about your project

      Title of project
      (Or the working title if it
      has not been finalised yet)



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     Start and end dates


      Proposed start date        /       /            Expected end date          /        /

             **Please note that the application process will take one month**

4)   The objectives of the Good Relations Programme
     To make sure you are eligible for a Good Relations Grant, you must show that
     the project contributes to at least two of the following. Please tick the
     appropriate box or boxes.

      Develop cross community contact and co-operation, by developing initiatives,
      which bring people from other traditions together.

      Promote greater mutual understanding by developing programmes of reflection,
      which aim to identify differences and similarities within and between
      communities.

      Increase respect for different cultures, by undertaking projects, which bring
      people from different traditions together to work on issues of common concern.

      Single identity work by groups who wish to gain a deeper understanding of their
      own culture and history and which MUST demonstrate a commitment to engage
      in future cross community contact outside their tradition, to build understanding
      and develop relationships.

5)   Describe how your project will contribute to the objectives you have ticked




6)   Please outline the main activities involved in your project.




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7)   Is the make-up of your group cross-community? please provide a percentage
     for each of the following categories.

     Catholic
     Protestant
     Other (please specify)


8)   The effect your project will have
     How do you think this project will improve good relations?




9)   Finance
     Please detail specific costs for which you require funding i.e. venue, transport,
     publicity, facilitators, refreshments etc.

                        Expense                         Cost (£)




                                    Total Cost
                        Amount Requested from
                   Ballymoney Borough Council


10) Please list other sources of funding for this project/event.




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11) Has your group received any previous financial assistance from Ballymoney
    Borough Council?      YES/NO (if yes, please give details)




12) Evaluating the project

    Please tell us how you are going to evaluate the outcomes of this project and who will be
    responsible for carrying out this evaluation.




13) What geographical area is covered by your group activity?




14) In accordance with the Council’s Equality Policy and Section 75 of the
    Northern Ireland Act 1998, please tell us how and where you are going to
    advertise this project to ensure that your event/project is accessible to
    everyone within the Good.




    * Please note any grant awarded by Ballymoney Borough Council must be acknowledged on all
                printed materials associated with your project by including our logo. *




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15) Who will benefit from your project?
     Please estimate the number of people who are likely to benefit from
     this project.



16) Declaration
    I declare that all information given is correct, and agree to abide by all criteria
    set out, should our application be successful. I agree to forward a completed
    monitoring form within three months of the project and any related press
    cuttings.

    Name (please print)

     Title (Mr, Mrs)              First Name                      Surname



     Signature                                                    Date



     Your position within
     the organisation




    CHECKLIST

     Copy of Constitution
     Evidence of financial position (i.e. Bank Statements or recent accounts)
     Recent Newsletter (if applicable)

                 NB-Please ensure that you have the above documents enclosed,
                 otherwise this may cause a delay in processing your application.




                                       Please return to:
                                          Claire Crawford
                                      Good Relations Officer
                                       Ballymoney Town Hall
                                        1 Townhead Street
                                            Ballymoney
                                             Co Antrim
                                             BT53 6BE

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