Dream Scheme Grant Application Form

To celebrate 50 years of charitable work Kenilworth Lions Club has launched its 2019 “Dream Scheme”. If you are a Kenilworth-based organisation or individual and you have a “dream” of a project which a grant of up to £1000 will help you to achieve then please submit an application using the form below. Before starting to complete the form please read the notes at the end for further details.

(If you would prefer to download a PDF version of the application form, please scroll to the bottom of this page.)

Applicant's Name*

Telephone Number*

Address*

Email*

Name of organisation (if applicable)

Organisation web site address (if applicable)

Tell us about your organisation - if applicable (50 words max)

Give us details of the project for which funding is required (200 words max)*

Anticipated project start date*

Anticipated project end date*

Total value of project (£)*

Funding already raised from elsewhere - if any (£)

Funding sought from Kenilworth Lions Club (£)*

Give precise details of what you intend to spend the funding on that you are seeking from Kenilworth Lions Club (100 words max)*

Give brief details (including the number of beneficiaries) of how the project will benefit*:

(1) You and/or your organisation:

(2) The Kenilworth community:

Have you or do you intend to apply to any other organisations for funds? Please identify the organisations applied to and the outcome if known:*

Have you previously received any funding from Kenilworth Lions Club?*

If "Yes", please provide the following information:

(1) Date of award:

(2) Value of award:

(3)Purpose of award:

ALL APPLICATIONS MUST BE SUBMITTED BY THE CLOSING DATE OF FRIDAY 1ST MARCH 2019

NOTES:
a) Projects must have a clear benefit to the people of Kenilworth and the immediate area;
b) Projects must have a visible outcome so that both the beneficiary and Lions Club can make the local Community aware of the results of the initiative through the local press;
c) Strong preference will be given to funding specific items or “one off” costs rather than to cover organisational running costs;
d) The Club may exceptionally provide 100% project funding but will normally expect the applicant to have raised an element of “matched funding” from elsewhere;
e) If the applicant has not raised sufficient money to allow the project to commence the Club may issue a certificate in the form of a “pledge” committing the Club to making the agreed payment once the applicant has raised the remainder of the funds. Such a pledge will normally only be valid for twelve months;
f) Funding will not be provided to support any national charity activities unless there is a direct, immediate and obvious benefit to the people of Kenilworth;
g) Funding will not be provided to individuals who are themselves raising funds to make as a personal donation to any local or national charity;
h) Applicants may be asked to discuss their proposal with a member(s) of the Club’s Community Services Committee if further clarification is needed;
i) On completion of the project applicants may be asked to present their project to a meeting of the Club
j) Applicants can expect to hear the outcome of their project application by the end April 2019.

GDPR Privacy Statement
Kenilworth Lions Club will securely keep the information given on this form locally on paper or in electronic format. It will only be processed in a way that ensures appropriate security of the information.
The information provided will not be shared with any other person or organisation without explicit permission from the information provider.
Relevant information will only be kept as long as necessary for the purpose of assessing applications, following up and contacting the applicant. All data will be securely destroyed within 4 weeks of the end of this project.

PLEASE NOTE THAT PRESSING "SEND" WILL GENERATE AN EMAIL TO THE KENILWORTH LIONS DREAM SCHEME CO-ORDINATOR, WHO WILL ACKNOWLEDGE RECEIPT IN DUE COURSE. IT WILL ALSO DELETE THE INFORMATION YOU HAVE ENTERED ON THIS FORM, SO IF YOU REQUIRE A COPY PLEASE MAKE IT FIRST. A SIMPLE WAY TO DO THIS IS USING THE "PRINT SCREEN" FUNCTION KEY ON YOUR PC.

If you want to download a PDF version of the application form, here is the link:   FORM

You can scan your completed form and email it back to us at kenilworthlionsdreamscheme@gmail.com, or alternatively post it to: Kenilworth Lions Dream Scheme, 40 Amherst Road, Kenilworth, CV8 1AH.