Step 1 of 9 11% COMMUNITY GRANT FUNDING 2020 – 2021 NAME OF ORGANISATIONTITLE OF PROJECTGrant AwardedDATE GRANT WAS AWARDED DD MM YYYY Follow the City Council on Twitter: @HfdCityCouncil or keep up with the latest news on facebook: HerefordCityCouncil Information about the organisation Title of ProjectName of OrganisationContact NamePosition in OrganisationAddress Address Line 1 Address Line 2 City County Postal Code Correspondence Address (If different from above) Address Line 1 Address Line 2 City County Postal Code Phone NumberEmail Address Website URL (If Applicable) Facebook Page Twitter Page Other URLsHow many members are there in the group?What geographical area does the organisation cover?How long has the organisation been in existence?Less than one yearBetween one and five yearsMore than five years SUMMARY OF THE PROJECT/EVENTBENEFITS OF THE PROJECT/EVENT TO THE RESIDENTS OF THE CITYAPPROXIMATELY HOW MANY RESIDENTS FROM WITHIN THE CITY OF HEREFORD BENEFITED FROM THE PROJECT FUNDING AWARDEDPlease identify and provide evidence of how the funding by Hereford City Council was spent in accordance with the award Capital Costs Acquisition of LandAcquisition of BuildingsConstruction/Adaptation costsFees, eg surveyor, planning (please attach breakdown)Fee Breakdwon Drop files here or Equipment and fittings (please attach breakdown)Equipment & Fitting Breakdwon Drop files here or Other Capital Costs (Please specify)Total Capital Costs Revenue Costs Revenue CostRevenue CostCost (£) Total of revenue costs Project Funding Please detail of local fundraising activities, if applicable. Local Fundraising ActivitiesEventDateAmount Please indicate what sources of funding the organisation were awarded for this project, if applicable.Awarded FundingOrganisationAmount Please give details of any help-in-kind received from other organisations, if applicable. Help In KindOrganisationHelp In Kind How many volunteers from the community, other than the members of the group were involved in the delivery of this project? Number of VolunteersWhat was their involvement? Supporting evidence of financial cost of the project/eventPlease attach final accounts for this project/event including invoices/receipts, profit and loss Drop files here or How did you monitor progress of this even/project & what were the achievements and outcomes? Evidence of completed project/eventPlease enclose leaflets, newsletters, photographs and/or any other material applicable Drop files here or Evidence of public recognition that this project was supported/funded by the city councilPlease enclose leaflets, newsletters, photographs, newspaper article and/or any other material applicable Drop files here or Please attach/send a selection of photographs covering project commencement to end. Drop files here or Declaration I confirm that the information supplied in this completion form and any accompanying papers is correct in all respects. I agreeI confirm that the grant has been used only for the purposes set out in the application and any supporting papers. I agreeI understand that any grant awarded by Hereford City Council not used in compliance with the terms set out in the letter of the grant award must be returned to the City Council and a cheque to that value should be included with this completion form I agreeE-signatureFull NamePositionDate The City Council would like to use uploaded project pictures on its website, Facebook page and Twitter for community information. 63517
