Ment Health Support Groups Grant Application Form

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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.

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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 individual carer friends simply wish to do something together.
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*

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About your group
Please 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 grant
- 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

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Please describe your group*
How does the group support members to improve their mental health and wellbeing?*
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 here
To add extra rows, click on + icon at the end of the row you've just completed.
Name Role

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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
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 below
Please 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*

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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 item Total cost
Please use this box to detail any website addresses 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 here
You can upload multiple documents if you need to
Drop files here or

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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*

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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 here

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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.

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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

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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
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 dataadmin@cornwallrcc.org.uk

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Mental Health Support Groups Grant Application

Step 1 of 11

Name	Role

What is the item/activity?	How many?	Cost per item	Total cost