Submit an Expression of Interest for a Shared Prosperity Fund Grant

By submitting this form, you agree to Mid Devon District Council using the information you provide for the purposes of the grant scheme administration.

Before completing this form, please tick this box to confirm that you have read the guidance notes, which provide essential information in relation to Mid Devon's Shared Prosperity Fund Grants

* required

Yes I have read the guidance notes

Confirm Eligibility: My business/ organisation/ project......

To confirm the basic eligibility of your project, you must tick all of the boxes below. If you cannot tick all the boxes, you will not be eligible to apply for a grant.

Legal status

* required

is either a registered business or charity, or is registered with HMRC for tax purposes, or is a public sector organisation

Location

* required

primarily operates and trades in Mid Devon

Logistics - the project must not have already started

* required

the project has not already started

Deliverability - that permissions are in place or not required

* required

Permissions are in place or not required

• Given the short time frame for expenditure and delivery, priority will be given to projects that are ‘fast to deliver and ready to go’. If permissions are needed e.g. planning permission (for works and/or change of use) – this should be obtained before making an application.

Agreement

* required

is prepared to cooperate with any due diligence checks and comply with the terms and conditions of the grant

Finance

* required

holds a UK based bank account in the name of the business/ organisation and does not have unmanageable debt

Equal Opportunities

* required

will not unfairly disadvantage anybody in terms of ethnicity, disability, age, gender, religious beliefs, marital status, gender reassignment or sexual orientation

Net Zero

* required

will not impact negatively on the environment

10.

Directors of other Enterprises

* required

the applicant(s) is/are not directors/ shareholders in another enterprise/organisation that has received Shared Prosperity Funding

Your Business/Organisation

11.

Business/ Organisation Name

* required

Maximum 255 characters

0/255

Provide your full registered business/ organisation name

12.

Trading Name

Maximum 255 characters

0/255

If you use a different trading name, specify it here. Leave blank if this does not apply.

13.

Address

* required

Maximum 255 characters

0/255

Address in Mid Devon

14.

Postcode

* required

Maximum 8 characters

0/8

15.

Website

* required

Maximum 255 characters

0/255

Provide the url for your main website, or state N/A if you do not have a website

16.

Business/ organisation Description

* required

Maximum 255 characters

0/255

Describe what your business/organisation does

17.

Type of organisation

* required

Select option

18.

When was your business/ organisation established?

* required

Maximum 255 characters

0/255

Registration Details

Provide at least one of the following:

19.

Tax Number

Maximum 10 characters

0/10

Your 10 digit Unique Tax Reference Number (UTRN)

20.

Company Number

Maximum 8 characters

0/8

If registered at Companies House, provide your 8 character registration number

21.

Charity Number

Maximum 255 characters

0/255

If registered at the Charities Commission, provide your 8 character registration number

22.

Business Rates Ref Number

Maximum 255 characters

0/255

Please provide the Business Rates Ref Number for the property where the proposed project will be located - You can find this on your latest business rates invoice

Your Contact Details

23.

Contact name

* required

Maximum 255 characters

0/255

24.

Contact telephone number

* required

Maximum 255 characters

0/255

25.

Contact email address.

* required

Please provide your email address so we can provide further information. Invitations to Stage 2 (full application/supporting information) will be sent by email to eligible applicants. (Please read the guidance carefully when applying.)

26.

Is the business/ organisation VAT registered?

* required

Select option

Your project proposal

27.

Project Name

* required

Maximum 255 characters

0/255

In no more than 6 words, give your project a name

28.

Project Location

* required

Please say if the the project will take place at the same location as the registered address? If not, please provide the address/ location of the proposed project.

29.

Project Need

* required

Describe the need for the project. Is there customer/ community need/ demand? Are you trying to solve an issue? Have you identifies an opportunity?

30.

Please give a brief description of the project you would like to propose.

* required

Describe your project in no more than 250 words. If your application is successful, what would you do and what difference would it make?

31.

Which Shared Prosperity Fund Grant Scheme do you wish to submit an Expression of Interest for?

* required

Select option

32.

Please describe what new or extended offer or services this project will enable you to deliver (additionality)

* required

This might include new space or facilities to offer new services, extended space, reach new groups etc.

33.

Project Costs - please upload your completed Grant Scheme costing sheet

* required

A Grant Scheme costing sheet is provided (please see sidebar), please complete and upload. This is a capital grant scheme which must be spent on lasting assets such as a building or equipment. Provide headline cost descriptions. Quotes are not required at this stage but it is expected that some research has been done to provide realistic costs. For each item, enter an item name or very short description and an estimated cost. Total project costs must not exceed £24,999.

34.

Earliest Start date

* required

Taking into account the grant decision making timescale, what is the earliest month in which you could start your project?

35.

Project Duration

* required

Maximum 2 characters

0/2

In months, how long do you anticipate it would take you to complete all of the work in relation to this project? Please take account of timings to minimise disruption to any current users.

Statement/ Disclaimer

You must confirm the declaration statements below

36.

All applications for grants may be reviewed in the future and you should be aware that if you make a statement which you know to be false or do not believe to be true to the best of your knowledge then you may commit a criminal offence. Mid Devon District Council is committed to the prevention, detection and investigation of any allegations or indications of fraud and will seek to apply criminal, disciplinary, regulatory and civil sanctions where allegations are proven. This includes the recovery of identified losses to ensure that all Public Purse resources are used for their intended purpose.

* required

Yes I have read and understood the above disclaimer

Sign Off

Please complete all mandatory information on this form before signing off

37.

Position

* required

Maximum 255 characters

0/255

38.

Name

* required

Maximum 255 characters

0/255

39.

Date

* required