Lloyds Bank Foundation Channel Islands

Page 1

Before you Start

Please contact the Executive Director to check your charity's eligibility and to discuss your funding request:

Jo Le Poidevin, jlepoidevin@lloydsbankfoundation.org.uk, 01481 706360.

Please read the Grant Programme Guidelines and Advice Note on completing your application prior to completing your application form.

Data Privacy

Please read our Data Privacy Notice before completing the form. We use Form Assembly to process our electronic forms. By using this application form (saving and submitting application form data), you agree to your application form data being processed on servers hosted by Form Assembly. Your data will be stored on servers in the UK. If your data is transferred outside of the UK, EU or EEA countries, suitable safeguards will be implemented to ensure compliance with UK, Bailiwick of Guernsey and Jersey Data Protection Laws.

For further information (including details on how to request a copy of your information) or to make a complaint about our use of your data, please contact the Executive Director, Lloyds Bank Foundation for the Channel Islands at jlepoidevin@lloydsbankfoundation.org.uk.

Saving your Progress

If you need to save and return to your application at a later date, please check the box at the very top of the form. This will let you enter an email address and password so that you can continue your application form later.

PART 1: CHARITY DETAILS

Please enter your registered charity number.

For Guernsey & Alderney charities - Guernsey Registry Charity Statement
For Sark charities – The Greffe Office Sark Certificate
For Jersey charities - Charity Commission Jersey Registration
For English charities - Charity Commission for England and Wales Registration

Date established as a charity

Please use the calendar or enter the date in the
format DD/MM/YYYY

Legal name of your charity

Building number/name

Street

Parish/City/Town

Post code

Island

Phone

Email address

Website

Facebook

Twitter

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PART 1 - CHARITY DETAILS (Continued)

Q1. Charity Classification
Please choose one of the following classifications that reflects the main focus of the work that your charity does.

Q2. Please provide a short history and background for the charity (including aims and objectives). (Max. 250 words)

Q3. Please briefly describe the charity's main activities and the benefits to the lives of the people you support. (Max. 500 words)

Q4. How are people with lived experience involved in the way that your charity is run? (Max. 250 words)

Q5. How do you track an individual person's progress? (Max. 250 words)

Q6. Please briefly describe up to three most important differences (outcomes) these activities will lead to in the lives of the people you support.

Please see advice on the definition of outcomes.

Outcome 1. (Max. 50 words)

Outcome 2. (Max. 50 words)

Outcome 3. (Max. 50 words)

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PART 3 - FUNDING REQUEST

Q20. How much are you Requesting from the Foundation?

(rounded to the nearest £100 per year)

Year 1

Year 2

Year 3

Total Requested

Q21. Please describe what the grant will fund. (Max. 500 words)

Q22. Is this grant application to support existing or new work?

ExistingNew

Q23. Preferred start date of grant.
Please note that we're unable to fund requests retrospectively, so you'll need to select a start date that falls in the future.

Q24. Number of people per year who will benefit.
Please enter a number rather than commentary.

Q25. The difference you will make (Outcomes):

Please briefly describe up to three most important differences (outcomes) these activities will lead to in the lives of the people you support. If the grant is funding core costs/activities, please use the outcomes in Part 1.

Please see advice on the definition of outcomes.

The outcomes will be used to monitor what difference you have made as part of grant reporting.

The difference you will make (Outcome 1). (Max. 50 words)

The difference you will make (Outcome 2). (Max. 50 words)

The difference you will make (Outcome 3). (Max. 50 words)

Q26. Are you the only organisation offering this service/support?

YesNo

Q27. Please explain why you are the right organisation to be providing the support and explain your track record of success. (Max. 250 words)

Q28. How is your service/support unique?
Who are your partners and how you will work in collaboration to avoid duplication and complement their delivery? (Max. 250 words)

Q29. What would happen if the service/support didn't exist? (Max. 250 words)

Q30. Please explain the social/community need you have identified.
Please tell us what you would like to achieve and the impact the grant will make to the lives of the people you support or how it will strengthen your charity to deliver more effectively (please include case study, links to films or testimonials from the people the charity supports). (Max. 500 words)

Q31. If this work continues beyond our funding period, what are your plans to fund and sustain it in the future? (Max. 50 words)

Q32. Please Provide a Detailed Breakdown of Costs

Total costs of the project (rounded to nearest £100)

Please specify each cost item, e.g., salary of Training Coordinator, volunteer travel expenses, office costs. List each item under a separate row and provide the cost for each year that you are seeking support.

Amounts should be entered without £ symbols, commas or full stops.

Budget Heading	Year 1	Year 2	Year 3	Total

Total Budget

Year 1

Year 2

Year 3

Grand Total

Q33. Funding Secured/Pending

Please tell us about the funding you have already secured and if you have applied to any other funders relevant to this funding request, including Government, States, Parish and other charitable trusts (rounded to nearest £100).

Amounts should be entered without £ symbols, commas or full stops.

Funding Source	Year 1	Year 2	Year 3	Status

Total Secured

Year 1

Year 2

Year 3

Total

Q34. How much do you Still Need to Raise?

(rounded to the nearest £100 per year)

Year 1

Year 2

Year 3

Total Needed

Please Confirm how much are you Requesting from the Foundation

(Note that if the below amounts are not correct, please change the requested amounts in Q20)

Confirm Year 1

Confirm Year 2

Confirm Year 3

Confirm
Total Requested

First name	Last name
Position in the charity	Telephone number
Main contact email address

First name	Last name
Position in the charity	Telephone number
Organisational contact email address