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12 Characters
1 Uppercase letter
1 Lowercase letter
1 Number
1 Special character
This application form must be completed in full and all required attachments submitted for the application to be considered.
Data Protection & Privacy Notice
To continue with this form, you must confirm that you have read our Data Protection & Privacy Notice, and consent to AVA storing the data as detailed within the policy. You can access our Data Protection & Privacy Notice by following
this link
.
I have read the Data Protection & Privacy Notice.
I consent to the data that I am providing below being stored by AVA in accordance with its Data Protection & Privacy Notice.
About You and Your Organisation
By providing your name and contact details, you are indicating that you are happy to be registered with AVA as being the main point of contact for the application.
Your first name
Your last name
Your role within organisation
Email address
This will be the email address that we use to contact you about your application.
Your phone number
This will be the phone number that we use to contact you about your application.
Organisation name
Organisation address including postcode:
Street Address
street address line 2
Street Address Line 2
town
Town
county
County
postcode
Postcode
Organisation email
Organisation phone number
Organisation primary purpose: Which of these most closely matches?
Children & Young People
Communities
Culture
Economy & Funding
Education
Environment & Conservation
Fair Work & Business
Health Wellbeing & Social Care
Human Rights
International
Poverty
Does your organisation have a constitution or governing document? If you are an unconstituted group, you should select No.
Yes
No
Would you like AVA to help you create a constitution or governing document?
Yes
No
Is there another constituted organisation that is willing to host the funds for you if you are successful?
Yes
No
A partnership agreement will need to be in place with a constituted group willing to hold funds on your behalf. Please make arrangements to put this in place before proceeding with your application as funds can not be transferred into a personal bank account. Please read the funding guidance here at
https://www.avashire.org.uk/cmhwfund
for further details about eligibility and the application process. Please seek further advice by completing our
Support Request Form
and a member of the team will get back to you.
Organisation legal structure: (The named legal structures are those that are stated in the eligibility guidance that AVA has received from the Scottish Government. If your organisation has a different legal structure then you may not be eligible to apply. You should seek advice from AVA by using the link at the top of this form.)
Community Amateur Sports Club
Community Benefit Society
Community Council
Community Interest Company (CIC) Ltd by Guarantee
Company Ltd by Guarantee
Co-operatives
Friendly Society
Industrial & Provident Society (IPS)
Parent Council
Scottish Charitable Incorporated Organisation SCIO
Trust
Voluntary/Unincorporated Association
None of the above
Based on the answer provided, your organisation/group is not eligible to apply for the Aberdeenshire Communities Mental Health & Wellbeing Fund. Please read the funding guidance here at
https://www.avashire.org.uk/cmhwfund
for further details about eligibility and the application process. Please seek further advice by completing our
Support Request Form
and a member of the team will get back to you.
Is your organisation a registered charity?
Yes
No
What is your charity number (including SC at the start)
Is your organisation a Social Enterprise?
Yes
No
Is your organisation an asset-locked social enterprise
Yes
No
Would you like to hear about our Social Enterprise Network?
Yes
No
Based on the answer provided, your organisation/group is not eligible to apply for the Aberdeenshire Communities Mental Health & Wellbeing Fund. Please read the funding guidance here at
https://www.avashire.org.uk/cmhwfund
for further details about eligibility and the application process. Please seek further advice by completing our
Support Request Form
and a member of the team will get back to you.
Bank Account & Financial Information
Does your organisation hold a bank account specifically for its activities?
Yes
No
Does your organisation have access to a bank account operated by another organisation who is willing to allow you to use it for the purposes of your application? If this is the case, you will be required to provide a letter from the hosting organisation to confirm this before any monies will be released by AVA to your organisation.
Yes
No
Bank account name
If a partner organisation is allowing you to use their bank account, this should be in their name.
x
Bank account sort code
(six numbers long in the format shown)
Bank account number
(normally eight numbers long)
Is your organisation VAT registered?
Yes
No
Total organisation income for the most recent audited or independently examined financial year.
Income higher than £1m is ineligible for this fund. Please refer to the guidance regarding the level of application that you can submit based on your annual income level.
x
Total organisation expenditure for the most recent audited or independently examined financial year.
Total unrestricted funds available as stated in the most recent audited or independently examined financial year.
A partnership agreement will need to be in place with a constituted group willing to hold funds on your behalf. Please make arrangements to put this in place before proceeding with your application as funds can not be transferred into a personal bank account. Please read the funding guidance here at
https://www.avashire.org.uk/cmhwfund
for further details about eligibility and the application process. Please seek further advice by completing our
Support Request Form
and a member of the team will get back to you.
About Your Application
What is the name of your project?
Will volunteers be involved in delivering your project and if so how many? This can be approximate.
Which of the following best describes the status of the activities outlined in your application?
New project
Existing project (funded through the Communities Mental Health & Wellbeing Fund)
Existing Project (new to Communities Mental Health & Wellbeing Fund but funded previously through another funding organisation)
Did you receive funding from this fund during either of the previous four rounds?
Yes
No
Please provide details of the impact this has created and how it is measured.
Are the activities outlined in your current application broadly compatible with the normal activities of your organisation?
Yes this is similar
No this is different
Please describe the project including its key aims and activities, and how this supports adult mental health and wellbeing.
Are you submitting an application on behalf of a partnership of organisations? If another organisation is allowing you to use their bank account, you must tick yes.
Yes
No
Please name the partner organisation(s):
Which of the following describes the type of activities outlined in your application?
Prevention: General inclusion activities that enable people to look after their own mental health and or wellbeing within their communities
Early intervention: Activities that enable people to take action when they feel that their mental health and or wellbeing is in the early stages of being compromised
Which of the following describe the purpose of your application? You can select more than one option.
Suicide prevention
Social isolation/loneliness
Addressing poverty and inequality
Other
Main purpose other
For addressing poverty and inequality projects, the following family types are considered to be most at risk of poverty. Please select any (or all) who you think are highly likely to engage with this project.
Lone parents
Families with a disabled family member
Families with more than 3 children
Minority ethnic families
Families where the youngest children are under 1 year old
Mothers aged less than 25
None of the above
Please describe who will be likely to benefit from your project:
Which of these best describes the activity of your project? You can only select one option.
Befriending
Peer support
Counselling
Therapeutic
Mentoring
Financial inclusion/cost of living
One to one
Group activity
Equipment
Food
Nature
Social
Arts and crafts
Maintenance/repair
Sport or physical activity
Culture
Other
Project activity other: Please identify what type of activity will be delivered.
Which of these best describes the beneficiaries of your project? Is your project for the general population (general), open to all but with a focus on particular target groups (targeted) or aimed directly at particular target groups (restricted)?
General
Targeted
Restricted
Which of the following groups will be most likely to benefit from the activities outlined in your application? You can select more than one option.
Carers and unpaid carers
Men at risk of suicide
Older people (aged 65+)
People disadvantaged by geographical location (particularly remote and rural areas)
People experiencing severe or multiple disadvantages
People facing socio-economic disadvantage
People from LGBTI communities
People from minority ethnic communities
People living with dementia
People who have experienced bereavement or loss
People who have experienced psychological trauma (including adverse childhood experiences)
People with a long term health condition or disability
People with diagnosed mental illness
People with refugee status, and those with no recourse to public funds
Women (particularly young women and women affected by male sexual violence)
People with neurological conditions or learning disabilities, and from neurodiverse communities.
Young people aged 16-24
Other
Group to benefit other:
How will your project support carers and unpaid carers?
How will your project support men at risk of suicide?
How will your project support older people (ages 65+)?
How will your project support people disadvantaged by geographical location (particularly remote and rural areas)?
How will your project support people experiencing severe or multiple disadvantages?
How will your project support people facing socio-economic disadvantage?
How will your project support people from LGBTI communities?
How will your project support people from minority ethnic communities?
How will your project support people living with dementia?
How will your project support people who have experienced bereavement or loss?
How will your project support people who have experienced psychological trauma (including adverse childhood experiences)?
How will your project support people with a long term health condition or disability?
How will your project support people with diagnosed mental illness?
How will your project support people with refugee status, and those with no recourse to public funds?
How will your project support women (particularly young women and women affected by male sexual violence)?
How will your project support people with neurological conditions or learning disabilities, and from neurodiverse communities?
How will your project support young people aged 16-24?
How will your project support other people not previously identified?
Expected start date of funded activity (must be in the future).
Expected end date (must be before 31st March 2027).
Where in Aberdeenshire will the activities outlined in your application take place? You can select more than one option.
Banff & Buchan
Buchan
Formartine
Garioch
Marr
Kincardine & Mearns
Aberdeenshire wide
Which of the following statements do you believe your project will contribute towards? You can select more than one option.
We are healthy and active
We will live in communities that are inclusive empowered resilient and safe
We tackle poverty by sharing opportunities wealth and power more equally
Costs
If your organisation is VAT registered, any figures you provide in relation to costings in this application should be excluding VAT. If your organisation isn’t VAT registered, you should provide costings inclusive of VAT.
Which of the following types of costs will this funding cover? You can select more than one option.
Equipment
Hall hire for community spaces
One-off event
Small capital spend (up to £5,000)
Staff costs (one off or fixed term only) at Real Living Wage level
Training
Transport
Utilities/running costs
Volunteer expenses
Equipment costs total
Please describe how you have calculated this overall equipment cost
Please identify each individual item that you expect to purchase, and its associated cost.
x
Hall hire/community spaces costs total
Please describe how you have calculated this overall hall hire/community space cost
e.g. hall hire hourly rate x number of hours you expect to use it during the period of the grant.
x
One-off event costs total
Please describe how you have calculated this overall one-off event cost
The individual things that must be paid for to make the event run smoothly, and the cost associated with each item.
x
Small capital spend total
Please describe how you have calculated this overall small capital cost
Up to £5,000 (i.e. land or building projects) Evidence must be provided that the applicant will have unhindered access to the land or building for 5 years after the funded project has ended, and where it is likely to be required, that full planning permission has already been granted.
x
Staff Costs
By placing a figure in this box, you are confirming that the staff will earn at least the Real Living Wage level for the duration of this grant.
x
Please describe how you have calculated this overall staff cost
The salary(ies), employer national insurance contributions and employer pension contributions should be included here. The salary calculation should include the hourly rate. IT equipment, office furniture etc for the postholder should be included in the equipment budget if this is required.
x
Training costs
Please describe how you have calculated this overall training cost
The name and costs of each training course should be provided, and you should identify who will attend each training course.
x
Transport costs
Please describe how you have calculated this overall transport cost
The mode of transport should be identified and if it includes car mileage, you should provide the mileage rate that will be paid and the total miles used in your calculation.
x
Utilities/running costs
Please describe how you have calculated this overall utilities/running cost
Each type of cost should be identified (e.g. electricity, rent, broadband) and the cost for each should be shown
x
Volunteer expenses
Please describe how you have calculated this overall volunteer expenses costs
These should be actual costs that volunteers are likely to incur (mileage should be included in the transport costs above). You should identify the cost types and the total for each.
x
What is the total amount of the grant that you are applying for?
This is an automatic calculation based on the figures you have places in the cost lines above. The total must be lower than £12,000.
x
Based on the total amount entered your application falls under Funding Level 1.
Funding Level 1: Up to £3,000. Maximum permissible annual income of £100,000
Funding Level 2: Between £3,000.01 and £12,000. Constituted groups only, maximum permissible annual income of £500,000
Funding Level 3: Between £12,000.01 and £45,000. Constituted groups only, maximum permissible annual income normally of £1m
Based on the total amount entered your application falls under Funding Level 2.
Funding Level 1: Up to £3,000. Maximum permissible annual income of £100,000
Funding Level 2: Between £3,000.01 and £12,000. Constituted groups only, maximum permissible annual income of £500,000
Funding Level 3: Between £12,000.01 and £45,000. Constituted groups only, maximum permissible annual income normally of £1m
Have you secured, or do you have access to funds that can also be used for this project in addition to the grant you are applying for?
Yes
No
How much is being contributed to this project from other funds?
Please identify what other funds you have access to for delivering this project (source and amount).
Funding Level 1: Applications up to £3,000 only
Please be as brief as possible, whilst providing enough information for application assessors to make an informed decision. Please do not assume that assessors know anything about your organisation or activity.
L1. What hardships have your service users experienced over the last 12 months that have had an impact on their mental health and wellbeing? You may wish to consider things like poverty, disability, social isolation, or rural isolation, and also describe the impact that those hardships have had.
L1. Please describe the activities that this grant would enable you to deliver.
L1. Who have you spoken to about the need for the activities you plan to deliver? You should briefly describe any conversations you have had with local partners, service users, and/or statutory services about the need for these activities.
L1. Please describe how the activities will help to improve the mental health & wellbeing of your service users.
L1. How many people do you think will take up the offer of the activity(s) that you will offer over the course of the funding period?
L1. How many direct beneficiaries are there likely to be?
L1. How many secondary beneficiaries are there likely to be?
L1: Will there be a charge for service users to access these activities? They should be free where possible and any costs kept to a minimum to ensure they remain accessible.
Yes
No
Ideally the service will be free at the point of access. Please note that this fund cannot support profit/surplus making activities.
x
L1: Why is there a charge for this service?
L1: How much will service users have to pay to access the activity?
L1. How do you plan to continue delivering this service once this grant has been spent? This might include allocating any unrestricted reserves that your organisation holds.
You will be required to upload the following applicable documents. All documents must have your organisation's name in the file name so that we know which files relate to which applications:
All applications: Most recent bank statement (dated within the last 3 months) showing bank account name, sort code, and account number.
All applications: Most recent annual accounts document (less than12 months old).
If your organisation is constituted: Your organisation's constitution or governing document.
If applicable: Partnership letter agreeing for another organisation's bank account to be used, using the template provided on the AVA website.
If applicable: Partnership letter outlining the names and contact details for each organisation, to include signatures of authorisation by a trustee of each organisation using the template provided on the AVA website.
If applicable: Evidence of planning permission being granted for an application that includes a request for a small capital grant if this is needed for the project to proceed.
L1. If your organisation is constituted, please upload your organisation's constitution or governing document. Alternatively, please upload the constitution or governing document of the group who will be holding funds for you.
L1. Please upload your most recent annual accounts document. Alternatively, please upload the most recent annual accounts of the group who will be holding funds for you.
L1. Please upload your most recent bank statement showing bank account name, sort code and account number. Alternatively, please upload the most recent bank statement of the group who will be holding funds for you.
L1. Please upload any other relevant documents required here. This might include a partnership letter or a letter of permission such as planning.
Funding Level 2: Applications between £3,000.01 and £12,000 only
Please be as brief as possible, whilst providing enough information for application assessors to make an informed decision. Please do not assume that assessors know anything about your organisation or activity. Unconstituted groups can not apply for grants of this size.
L2. What hardships have your service users experienced over the last 12 months that have had an impact on their mental health and wellbeing? You may wish to consider things like poverty, disability, social isolation, or rural isolation, and also describe the impact that those hardships have had.
L2. Please describe the activities that this grant would enable you to deliver.
L2. Who have you spoken to about the need for the activities you plan to deliver? You should briefly describe any conversations you have had with local partners, service users, and/or statutory services about the need for these activities.
L2. Please describe how the activities will help to improve the mental health & wellbeing of your service users. You should make direct reference to each of the hardships that you described your service users as having experienced.
L2. With the help of this grant, how many people do you think will take up the offer of the activity to over the course of the funding period?
L2. How many direct beneficiaries are there likely to be?
L2. How how many secondary beneficiaries are there likely to be?
L2: Will there be a charge for service users to access these activities? They should be free where possible and any costs kept to a minimum to ensure they remain accessible.
Yes
No
Ideally the service will be free at the point of access. Please note that this fund cannot support profit/surplus making activities.
x
L2: Why is there a charge for this service?
L2: How much will service users have to pay to access these activities?
L2. How do you plan to continue delivering this service once this grant has been spent? This might include allocating any unrestricted reserves that your organisation holds. You should describe what you will be doing to try and secure the continuity of the activity that you are requesting funding for.
You will be required to upload the following applicable documents. All documents must have your organisation's name in the file name so that we know which files relate to which applications:
All applications: Most recent bank statement (dated within the last 3 months) showing bank account name, sort code, and account number.
All applications: Most recent annual accounts document (less than 12 months old).
If your organisation is constituted: Your organisation's constitution or governing document.
If applicable: Partnership letter outlining the names and contact details for each organisation, to include signatures of authorisation by a trustee of each organisation using the template provided on the AVA website.
If applicable: Evidence of planning permission being granted for an application that includes a request for a small capital grant if this is needed for the project to proceed.
L2. If your organisation is constituted, please upload your organisation's constitution or governing document.
L2. Please upload your most recent annual accounts document.
L2. Please upload your most recent bank statement showing bank account name, sort code and account number.
L2. Please upload any other relevant documents required here. This might include a partnership letter or a letter of permission such as planning.
Declarations
PLEASE NOTE: All applicants will be required to complete the following section.
I have read the guidance provided by Aberdeenshire Voluntary Action on its website, and it has been considered whilst preparing this grant application. I have read the Data Protection & Privacy Notice.
I understand that this fund is to provide services that support adults (16+ years) only.
I declare that if the organisation I am completing this form for has applied to any other fund, or received any other financial support to deliver the activity(s) that have been described in this application, I have declared it.
I understand that if for any reason our capability to deliver the project changes, I must inform Aberdeenshire Voluntary Action and seek their guidance on how best to proceed.
I understand that if there is an underspend on the grant, I must report it to Aberdeenshire Voluntary Action, and that the underspend may have to be repaid.
I understand that where two signatories or more are required on the designated bank account, the named people must not be related.
I understand that I will be required to provide an evaluation of the project if I receive a grant.
I understand that assessment priority will be given to applications from organisations with annual income lower than £50,000 and who have not applied previously. I also understand that if my application does not meet these criteria, it may remain unassessed if demand for the fund is high.
Signature & Submission
Please type your name here. This will act as your signature on behalf of your organisation.
Please insert the date on which you are submitting your application.
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