Mental Health Support Groups Grant Application Form Mental Health Support Groups Grant Application Step 1 of 12 8% Save and Continue Feature Please note, this application form can be saved partway through. Please click the Save and Continue Later button at the bottom of any page. You will be asked to supply your email address and you will be emailed a link to your application form so that you can continue to complete it at a later date. All questions marked with an asterix* require an answer and cannot be skipped. You will need to complete all questions with an asterix* before moving onto the next page. Data Protection CRCC complies with the EU General Data Protection Regulations and the Data Protection Act 2018. By sending this form to us, you agree that we can securely store your personal information on our database or in the form of paper records, and that we can use your information in order to provide a service to you as part of the Wellbeing Community Grants Programme. We will only collect and process information in accordance with the legal basis for the service you are receiving. We will not sell your information or share it with any other organisations. We will not keep this information longer than necessary (this is normally for two years following the end of the contract year); it will then be securely destroyed. Our full Privacy Statement is available on request and can be viewed on our website at www.cornwallrcc.org.uk/policies-procedures If you wish to withdraw your consent, or if you wish to see a copy of the information we hold about you, please forward your request to the Grants and Compliance Lead on 07715 799395 or email dataadmin@cornwallrcc.org.uk Please note, for the benefit of this grant, a formal group is one that has a group name, meets regularly throughout the year and has a bank account in the group's name. An informal group is where individuals meet for mutual support but do not have a bank account in the group’s name or have an organisation willing to hold funds on the group’s behalf. Have you read and understood the Terms and Conditions that accompany this application form?* Yes No - please get in touch with us with any queries before continuing Name of group* Name of organisation (if applicable) Your name*Contact name must be someone who can answer any queries about the group’s grant application Your position in the group or organisation*e.g. group member, independent facilitator, Community Outreach Advisor, etc Your contact address and postcode*Daytime telephone number* Email* About your groupPlease tick to confirm your group is not commissioned by Cornwall Council, NHS Kernow or IoS Council* not commissioned If you are an organisation applying for funds for a support group, please tick to confirm you will not benefit from funds from the grantYou will need to complete a Financial Declaration form available from CRCC We will not benefit financially from this grant Formal groups: please tick to confirm that your group has Public Liability Insurance for activities & meetings*This is a requirement of funding. For new groups: this grant can fund insurance so please include this in your costings. Yes we have PLI No but we are requesting funds for this in this application N/A Does your group have a Safeguarding Vulnerable Adults policy?*If no, we may need to contact you to discuss how you are able to support vulnerable people and to help you in creating a policy for your group. Yes we have a SVA policy No we do not have a SVA policy Please describe your group and explain how it supports members with their mental health*How many people attend your group?* How many carers/ friends/ family attend your group (if applicable)? How many volunteers (if applicable)? Please tell us how your group is complying with government rules for Covid-19 around social distancing, etc.*Group members are expected to be involved in the planning of group activities and decisions about how the grant might be spent. Please explain how your group involves its members.*Formal groups are required to have a steering group or committee (e.g. Treasurer or Secretary)that oversees the grant spend. Please tell us about these people hereTo add extra rows, click on + icon at the end of the row you've just completed.NameRole Your funding request Please tell us here what you would like funding for and how much money you would like. We regret we cannot pay solely for one-off activities, e.g. days out or events. Activity costs must be part of a request for general running costs How much money are you requesting?* Have you had a grant from us before?* Yes No When was the last time you had a grant from us? Month/ year* Have you sent us your feedback report and relevant receipts?* Yes No - You can still apply but you will need to send these to us before we can award a further grant What would you like funding for?* General group running costs Start-up costs (£500 max) Tablets / mobile hub costs (additional £500 permitted for formal groups)) Please summarise what you'd like funding for*How will these items/ activities support people with mental health issues?*If you are applying for tablets/ mobile hubs, please answer the 4 questions belowPlease confirm that the devices will be owned by the group but will be loaned out to members who need them to connect with other members online* Yes the devices will be owned by the group Please confirm that members will be supported to connect online safely* Yes we will ensure members understand internet safety Please explain why other sources of funding for these items are not available or applicable*Please explain how members will be supported to increase their skills and independence to connect online* Where possible, please provide below a detailed list of costs that you would like the grant to fund below. You can change your mind about activities you list later but we need to see a budget. Please submit evidence of these costs with your application. We need to know how you worked out your costs so please send us quotes, etc. You can either upload documents below or email them separately to grants@cornwallrcc.org.uk Please check the Terms and Conditions for details of what the grant can and cannot be used for.Costings*Please list each item or activity on separate rows. To add extra rows, click on the + icon at the end of the row you've just completed. Examples: ITEM - HOW MANY - COST PER ITEM - TOTAL COST Room hire - 50 weeks - £15 per week - £750 Mindfulness training - 5 weeks - £25 per person - £125 Refreshments - 50 weeks - £5 per week - £250 What is the item/activity?How many?Cost per itemTotal cost Please use this box to detail any web links that evidence where you got your costings from.If you supply website addresses, please ensure the webpage details the costs you are quoting in this application form. We regret we are unable to accept Facebook pages as evidence of costs. If you wish to upload evidence of costs please do so hereYou can upload multiple documents if you need to Drop files here or Select files Max. file size: 64 MB. Your bank details If your application is successful, payment will be made directly into your group’s bank account. The account must be in the group’s name and have at least two signatories. We may agree to pay funds instead to a sponsoring organisation providing we have a Financial Declaration from that organisation’s Finance Officer or similar. Please call Sharon on 01872 243535 for a copy of the form. Bank account* We have a group bank account An organisation will hold funds on our behalf Name of bank/building society* Account name* Account number* Sort code* Professional referee All groups applying to the grant must provide a reference from a local professional or local recognised organisation who can vouch for/endorse the aims, objectives and support mechanisms of the group. If you have already applied to this grant this year (April 2020 to March 2021), and so have already given us a reference, please leave this section blank. You will need to send the reference to us, ideally with your application, before the application deadline. Please send the reference to us by email to grants@cornwallrcc.org.uk or upload your reference below. It is your responsibility to ensure we receive your reference before the application deadline. Please tick to confirm that your reference is accompanying this application form or is being sent separately by the referee* Yes, is uploaded below Yes, is being sent separately We have applied to you already this year and so do not need to submit a reference If you wish to upload your reference, please do so hereMax. file size: 64 MB. Declaration and agreement*Please tick all boxes to indicate your agreement I agree to the Terms and Conditions of the Mental Health Support Groups Grant set out in the guidelines that accompany this grant We will only use the grant for the items or activities stated in our application or we must get permission from CRCC first to make any changes I understand that if CRCC is not satisfied with how the money has been used we may be asked to repay some or all of the grant. I am submitting evidence of the costings relating to the items/activity that we are requesting a grant for, e.g. quotes or website addresses, etc. I understand that this grant cannot be used for items/activities already paid for. I agree to complete a feedback report as requested and agree to send in all relevant receipts by 30 June 2021 I understand that if I leave the group, I will ensure someone else in the group will take responsibility for the grant and inform CRCC of this. I have read the Data Protection statement in the Terms and Conditions and agree to how CRCC will hold/use my details. I confirm that the information provided in this application is true and accurate to the best of my knowledge. Would you like to join our mailing list?*We occasionally send out emails to advise people of events and services that may be of interest to them, including updates on grant programmes. You can choose from the list below which type of emails you would be interested in receiving. You can unsubscribe at any time using the link at the bottom of each email. We will not share your name and email address with any other party. Click here to read our Privacy Statement Yes please No thanks Please select your mailing list preferences*Please tick ALL that apply Grants - we will only contact you with information about our grant programmes Other CRCC info - receive occasional emails about other services we offer About other approved services and organisations Next steps You should automatically receive a copy of this form by email after you click SUBMIT. Please retain this copy as you may need to refer to your application form if we have any queries, plus you will need to refer to it when completing a feedback report. There are 5 grant rounds this year. Please note the following application deadlines and ensure you have all relevant documents to us by the dates below. 11 September 2020 6 November 2020 18 December 2020 26 February 2021 14 May 2021 Additional information Our address is: Grants, CRCC, 2 Princes Street, Truro TR1 2ES If you need to call us, our number is: 01872 243535 Our email address is: grants@cornwallrcc.org.uk
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