APPLICATION FORM SUMMARY

Please take this opportunity to review your form before it is submitted. If you are happy with the contents and wish to submit this to SUEZ Communities Trust please click "Submit".

If you want to amend the information provided please click "Amend".

1 *Name of applying organisation
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2 Applying organisation's main address *Address1:   ?
  Address2    
  Town:    
  County:    
  *Postcode:    
3 Main contact title
(eg. Mr, Miss, Mrs etc)
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4 First name
      
5 Last name
      
6 Position
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7 Main contact and correspondence address *Address1:   ?
  (Complete only if different from address provided in Q2) Address2    
  Town:    
  County:    
  *Postcode:    
8 Main contact telephone number
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9 Alternative main contact telephone number
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10 *Main contact email address
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11 Please describe the applying organisation
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12 If the applying organisation has a website please provide the URL/web address
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13 If the applying organisation is active on social media (i.e. facebook or twitter) please provide the relevant account names
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14 Does the applying organisation have a bank account open in its own name
(Please answer Yes or No
      
15 If the applying organisation is a body approved by SEPA please enter your approval number here
      
16 Have you applied, or do you intend to apply, to other SLCF approved bodies for funding for this project? If yes please provide further details
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1 Project title
(maximum 100 characters)
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2 To which fund are you applying
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3 Which main SLCF object is your application for
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4 Project site address *Address1:   ?
  Address2    
  Town:    
  County:    
  *Postcode:    
5a Please provide a brief description of the overall project being undertaken at the project site
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5b Overall project costs
(Please read the help text (?) before proceeding)
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6a How much funding has already been secured towards the overall cost of the project
(Please do not include funds you have allocated for your CTP payment in this section)
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6b Please describe the source of secured funds
(Please do not include funds you have allocated for your CTP payment in this section)
      
7a Amount requested from SUEZ Communities Trust
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7b Please give a full description of your project focusing on how you specifically intend to use any funds awarded from SUEZ Communities Trust
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7c Does the amount include VAT
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7d Is the applying organisation able to reclaim VAT
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8a How much funding remains to be secured in addition to the amount requested from SUEZ Communities Trust
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8b If funds still need to be secured in order to complete the overall project please explain where you anticipate obtaining the necessary funds from
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9 Project start date
(Please select a month and year from the look up tables)
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10 Project end date
(Please select a month and year from the look up tables)
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11 What insurance policies does your organisation have for this project
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12 Who owns the project site
(Maximum 50 Characters)
      
13a If you do not own the project site, there must be a current lease in place between the applicant organisation and the site owners that has at least 5 years to run. Please confirm the name of the lessee and how many years are left on the lease
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13b Please give the date your lease commenced
      
13c Please give the date your lease will end
      
13d What is the length of your lease
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14 Please provide the name of your local newspaper(s) for the area around the site to be funded
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15 Please tell us who is the local constituency Member of the Scottish Parliament (MSP) for the site where any funding provided by SUEZ Communities Trust will be spent
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16 What evidence do you have that there is local support for this project
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17 If your project requires any consents, licences or permissions that are outstanding please indicate when you expect to receive them
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1 Please provide the name of the nearest landfill site or transfer station to the project site
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2 Distance between project site and landfill site or transfer station
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3 Please explain how the project site is for the protection of the environment and what environmental considerations will have been incorporated into the completed project
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4 Name of the organisation that will run the amenity being funded by SUEZ Communities Trust
(Maximum of 50 characters)
      
5 If the provision of the public park or amenity or the delivery of this project is required by statutory notice, order or agreement or under the terms of a planning permission or consent please give details
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USERS AND OPENING HOURS

We are trying to build up a picture of your amenity, who currently uses it, when it is available to the general public and who stands to benefit from any improvements made to it. The project should benefit a wide range of users of all ages and abilities

      
6a What is the current number of users of the amenity
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6b What is the anticipated number of users of the amenity after completion of the project
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6c What is the current annual footfall for the amenity
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6d What is the anticipated annual footfall for the amenity after completion of the project
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You have already stated that the amenity is open to the public for a minimum of 104 days per year. Please give more detail in this section about any membership scheme you have in place, opening hours and how the amenity is advertised and promoted locally.
      
7a Please give details about any membership scheme which is in place
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7b How do you advertise the availability of the amenity
      
7c To give us a better picture of how your leisure amenity is used please can you provide us with information about opening hours and regular current users of the amenity on a typical week
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MONDAY
      
TUESDAY
      
WEDNESDAY
      
THURSDAY
      
FRIDAY
      
SATURDAY
      
SUNDAY
      
Please give details of any potential groups who have specified an interest in using the facility after work has been completed including if possible details of when they will use the facility
      
Please detail any ad hoc, irregular or one off events or meetings that take place in your facility including frequency (e.g. once a month, yearly, one-off)
      
8 Is the building, structure or site a place of religious worship, or of historic, archaeological or architectural interest
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9 If the building, structure, or site has a national or local designation please describe the designation
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10 Why is the repair/restoration/improvement work you are proposing necessary
      
1 Please provide the name of the of the nearest landfill site or transfer station to the project site
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2 Distance between project site and landfill site or transfer station
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3 Which habitat or species is the focus of your application
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4 Please describe the proposed practical conservation work and explain how this will benefit the focus habitat or species
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5 Please detail the contributions that the project will make to relevant conservation plans or strategies
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6 If any of the proposed work is taking place on a SSSI or is a requirement of any statutory notice or order please provide details here
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7 How will the project outcomes be monitored and recorded
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8 Describe how the project will be sustained after the support from SUEZ Communities Trust has ended
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1 Please provide a full description of the proposed project
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2 If any of the proposed work is required under a statutory notice, or under the terms of a planning permission or consent please give details here
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1 Will any income be generated as a result of SUEZ Communities Trust funding. If yes, please describe
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2 Have you identified a Contributing Third Party (CTP) provider? If yes, please provide details. If no, please insert "No" and any additional comments you think may be helpful
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3a If your project requires the use of a supplier or contractor have you received 3 quotes
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3b If the answer to question 3a is no, please explain why
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4a Is there any connection between the applying organisation and any supplier/contractor being employed to deliver any element of the project. If yes, please describe
      
4b Is there any connection between the CTP provider and any supplier/contractor being employed to deliver any element of the project. If yes, please describe
      
5a If the applying organisation's latest set of accounts are available on line please provide the web address here
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5b Has there been any material change to the applying organisations financial position since the accounts submitted with this application were published. If yes, please describe
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6 How will you demonstrate that best value for money will be achieved throughout the project
      
1 Two photographs to support your application
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Attach second photograph
        
2 A completed Project Budget. This is a SUEZ Communities Trust document which all applicants must complete and attach. Please ensure you read the help text (?) to find out how to access the document.
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3 A maximum of 3 letters of support
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Attach second letter of support
        
Attach third letter of support
        
4 Please attach quotes from suppliers or contractors
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Attach second quote
        
Attach third quote
        
5 If the applying organisation's latest set of accounts are not available on-line please attach a copy
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6 You can also attach any other documents you think would support your application on this page of the form.
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Attach second document
        
Attach third document
        
1 Do you intend to send supplementary information by post
      
2 If the answer to question 1 is yes, please provide details here
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3 Please provide details of any other documents attached in Question 6 of the "Attachments" page
      
4 Additional information or comments
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*DECLARATION 

Please confirm on behalf of the applying organisation detailed in question 1, on the first page of this form, that you are duly authorised to submit this application and that, to the best of your knowledge and belief, all answers to the questions are true and accurate.

      
1 How did you hear about SUEZ Communities Trust
      
2 If you emailed SUEZ Communities Trust before completing the application form, did you have a timely, satisfactory response
      
3 If you spoke to someone at SUEZ Communities Trust before completing the application form, how would you rate the quality of information you were given
      
4 How easy was it to complete the online application form
      
5 Are there any service improvements you would like to recommend
      
6 If you would like to make any other comments, please do so here
      
7 Please give an overall score for the service you received. 5 = very satisfactory, 4 = good, 3 = satisfactory, 2 = unsatisfactory, 1 = poor
      
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