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					     STOCKWELL
       URBAN II
Application Form
 Project Title:



 Project Applicant:




Completed application forms to be returned to:

URBAN II Programme Co-ordinator
Community Renewal
London Borough of Lambeth
Town Hall
Brixton Hill
London
SW2 1RW




                                                 1
SECTION A: APPLICANT AND PROJECT BACKGROUND DETAILS


1. Applicant Details:

Name of organisation

Type of organisation

Registered No.(s)

Contact Details -

Name:

Address:



Tel:                               Fax:

Email:


2. Project Detail:

Project Title:


Brief Description (not more than 100 words)




Project Priority & Measure:

Amount of ERDF requested:

Amount of Matchfunding provided:

Project start date:

Project completion date:




                                                      2
3. Project Applicant Declaration:

On behalf of (project applicant organisation):

…………………………………………………………………………………

I certify that the information provided in this application, which will be
used in any subsequent grant approval contract, is complete and accurate;
that our organisation has the necessary authorisation and legal powers to
enter into a contract to implement the project and receive grant funding.

Signed:


Date:


Name:


Position held in your organisation:




                                                                             3
SECTION B: PROJECT DETAIL


4. Project Justification
Please state why you think this project is necessary, and indicate how you have
identified the need.




                                                                                  4
5. Location and population coverage:
Please state where the project will be located and estimated numbers of the local
residents that will be supported.




6. What does the project intend to do?
State clearly and succinctly what the project intends to achieve and how this is to
be done.




                                                                                      5
7. Who are the intended beneficiaries of the project?
Provide details of who the intended beneficiaries are and how they are expected to
benefit from the project.




8. Project Outputs
Please complete the following table, stating all key outputs of the project in
relation to the entire costs of this proposal


Output                                                                 Quantity

e.g. Individuals assisted through capacity building and                25
participation measures, of which 60% are women




                                                                                     6
Project Outputs – additional information
(Complete if appropriate)




9. Links with other initiatives
Please think carefully about how your project links with other initiatives, both
locally and nationally and provide details of the initiatives and how linkage is to be
achieved.




                                                                                         7
Notes for Assessors:




                       8
SECTION C: STATUTORY PERMISSIONS


10. As part of this application you will need to confirm that you have obtained
the necessary statutory consents and permissions to implement your project.
Evidence of these permissions must be attached to your Project Application.


                                                        (Please tick as applicable)

 Permissions:                                           Yes        No         N/A

 Do you have legal authority to undertake the
 project?


 Do you own the building or have tenure on the site?


 Do you have full planning permission?


 For infrastructure projects –
 Has a detailed cost appraisal been undertaken?




Note for Assessors:




                                                                                      9
SECTION D: PROJECT FINANCES


11. Total project costs
Provide a detailed breakdown of your total projects costs. Identify how your ERDF
and match funding would be spent, ensure allocated spend under the project is
clearly demonstrated.

Please Note: in-kind contributions will need to have a cost allocated to them and
you will need to demonstrate how you calculated this figure. Please refer directly
to the bidding guidance for eligibility criteria, which will explain what you can
and cannot claim.

ITEM                                          ERDF Amount         MATCH
                                              (£)                 Amount & Source

e.g. Tree Planting                            £5,000              £5,000 (DTLR)




Total Project Costs:



12. Project Matchfunding
Please provide detail for all sources of eligible project matcfunding
Source of Matchfunding                                 Date        Evidence provided
                                                       approved    (please tick)




                                                                                       10
13. Value for money
Please provide information on how you have and will continue to ensure that your
project provides value for money




SECTION E: PROJECT PLAN


NOTE TO APPLICANTS:
Either: if your total project value is in excess of £30,000, answer Question 14 then
move straight to Question 18
Or: if your total project value is £30,000 and less, answer Questions 15 – 17.



14. Project Business Plan (Project value £30,000 plus)

For project with a total project value in excess of £30,000, please provide a Business
Plan. Use Annex 4 of the Bidding Guidance as a guide.
Attach Business Plan to the project application and upon completion go to Question
18 of the Project Application




                                                                                         11
15. Project timetable (for project’s with a value £30,000 and below only)
Provide a timetable of activities for project, including key project milestones that you
intend to achieve.




16. Project Risk Assessment (for project’s with a value £30,000 and below only)
Provide a realistic assessment of the potential risks, which may affect your project’s
delivery and what you intend to be achieved, and detail the actions that have and/or
will be taken to minimise these risks.




                                                                                      12
17. Project implementation (for project’s with a value £30,000 and below only)
Please provide details on who is to be responsible for the implementation of the
project. You must include detail on who will be responsible for management of the
project delivery and the use of ERDF grant.




                                                                                    13
18. Formal community consultation
Please describe what formal consultation has taken place to support this project




19. Community consultation and involvement
Please describe how local people will be involved and how they will benefit from this
project




                                                                                   14
SECTION G: BEST PRACTICE


20. Experience
Please provide details of any previous experience you have of running a project
similar to this, especially any experience you have of a project using European funds.
If you do not have any previous experience, the assessors would prefer you to say so.




21. Sharing of best practice
Please give details on what approaches will be implemented to ensure lessons learnt
from delivering this project will be disseminated and shared. Approaches taken must
ensure transferability of knowledge and experience gained to benefit future projects
and initiatives.




                                                                                   15
22. Project and Programme Promotion
It is a formal requirement of all projects to acknowledge the receipt of ERDF and
promote the benefits of the European funds. Please describe how and what methods
will be used to publicise the project and the URBAN II programme.




Notes for Assessors:




                                                                                16
SECTION H: CROSS CUTTING THEMES


23a. Equal Opportunities
Please describe how you will ensure the implementation of Equal Opportunities
throughout the project
(Refer to pages 28-29 of the Programme Complement as a guide)




23b. How many (in percentage proportion) of the intended beneficiaries will be:
(Refer to page 29 of the Programme Compliment)

WOMEN

BLACK

OTHER ETHNIC MINORITIES

DISABLED




                                                                                17
24. Sustainable Development
Please describe how your project will contribute to the principles of sustainable
development in the area.
(Refer to pages 30-31 of the Programme Complement as a guide.)




25. Information and Communication Technologies (ICT)
(Refer to pages 31-33 of the Programme Complement as a guide)

25a. Does the project provide facilities which allow local residents to access and
familiarise themselves with ICT?

If Yes, please provide details on how this is to be achieved




If No, please explain why




25b. Does the project contribute to the transition of an information society in
Stockwell?

If Yes, please provide details on how this is to be achieved




If No, please explain why




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