The Hilden Charitable Fund

charity number: 232591

Summer Play Schemes Application Form 2013

The Fund has allocated a small budget to help community groups run Summer Play Schemes, for disadvantaged communities. Some priority will be given to projects which show they are inclusive of children from  refugee families, and show BME involvement.  Grants awarded range from £500 to £1,500.

Guidelines

Applicants are required to: 1. Complete this form in full 2. Give a brief description of the scheme and programme activities 3. Give full budget details (including details of other funders) 4. Send a copy of your most recent annual report and accounts (which must include a list of Trustees/Board members)

Contact  Details                                                                          Date Sent: (dd/mm/yyyy)

1. Full name of Organisation

2. Name of Contact Person

3. Contact e-mail

4. Contact phone number

5. Address                                                                                       Post code

6. Have you had a Summer Play scheme grant from Hilden before?        Yes      No

7. If YES, amount of grant and date given

8. Do you have UK charity status?   Yes    No    If Yes please give your charity number  If No please explain your charitable purpose or arrangements with another charity and give details

IF a grant is awarded, which Payee should the cheque be payable to?

Please answer these questions

1. Where will most activities take place?

2. How many children in total will be involved in the scheme?

3. Of those how many are:      5-11       12-14        over 15

4. What ethnic background do the majority of the children come from? If not relevant put "General"

5. What is the duration of the scheme? eg 2 weeks

6. Are any special trips planned?  Please give brief details

7. What is your overall budget for the scheme?         What amount are you requesting from Hilden?

8. Please give details of the person responsible for the management of the scheme

9. Please give brief details of his/her experience to run such schemes (if possible attach a CV)

Health and Safety and Insurance

10. Have you ensured there is adequate supervision of the children at all times?     Yes    No

11. Have you ensured all necessary health and safety matters have been checked, and for sports and adventure activity, qualified personnel        are in supervision?                                                                                                      Yes    No

12. If using a minibus, has it been supplied by a reputable supplier and does it meet all necessary safety requirements,  including seat belts for every passenger?                                                                        Yes    No

13. Please give details of your public (and other) liability  insurance

14. Date of renewal

15. Policy number

16. Do you undertake relevant checks on staff and volunteers?                                    Yes    No    Not relevant

17. If Yes  are you registered with                                                                                       Criminal Record Bureau    Umbrella Body    Other

Finally please return by post this completed form and the documents requested in the Guidelines above to: Hilden Charitable Fund 34 North End Road, London W14 0SH

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