Cambridge City Council

United with Ukraine Grant
Tier 3 Application Form 

 

Before starting your application
Please note this application form is only for Tier 3 applications. Tier 1 and Tier 2 applications should be submitted online and will not be accepted if made using this form.

Please read the Application Guidance (Help Notes) carefully to ensure:
•	you understand what is required from each question
•	you send in all the required documents with your application
•	you know how we will process your data

    Important note
•	Grant awards are based on the information contained in this application form
•	Grant awards must be spent only on the purpose detailed in grant agreements and in accordance with information and budgets contained in this document  
•	Grant awards that are not spent for the purpose allocated will need to be repaid 

We need information about the applicant, activities and how you intend to deliver and monitor them so that we can assess your grant application.

Full name of organisation
(as on your governing document)		

Priorities

1.	Which of the funding priorities does your application meet?  Please tick which priority area you are submitting your application for. Please only tick one priority, unless you are requesting funding for multiple activities.
A	Navigating life in the UK
		
B	Promoting community cohesion and integration
		
C	Delivering money advice and management
		
D	Supporting access to employment
		
E	Increasing confidence in speaking English
		
F	Enhancing wellbeing, including activities for children

Working with refugees

2.	Please summarise the experience of your organisation delivering activities funded by the United with Ukraine (UwU) grant, or the track record of your organisation working with refugees and asylum seekers in the UK. Please note only groups with experience of delivering UwU funded projects, or with strong track record of working with refugees, can apply for a Tier 3 award.
    See Help Notes Q2 

2a. Please let us know what connections you have with refugees fleeing the war in Ukraine who live in Cambridge. Please note that organisations without a strong connection to refugees from Ukraine based in the city will need to contact us before applying to discuss their eligibility.

See Help Notes Q2a

3.	Please share one or more examples of positive change that’s been brought about by the work undertaken by your organisation. This should illustrate how your organisation has successfully supported and/or created improved outcomes for refugees and asylum seekers in the UK.
See Help Notes Q3

Activity
 
4.	What specific activity do you want funding for? 
It is important you include all details as specified in the Help Notes and read the 'Important note' on page one of this application form.  (Please ensure you have permission from the landowner if your activity is taking place on land you do not own. For City Council owned land, you will need to complete a ‘Notice of Intent’ and should allow 4 weeks for a decision to be made. https://www.cambridge.gov.uk/hire-a-park-or-open-space-for-your-event). 

See Help Notes Q4

5.	How have you, or will you consult with or involve your beneficiaries in planning the design and development of the activity? 

See Help Notes Q5

6.	What partners are involved in helping you deliver this activity? See Help Notes Q6

Organisation or individual	How are they involved?	

7.	How will you ensure that you will provide a high-quality and culturally appropriate activity?  
Please list any quality accreditations held by the organisation, for example: Advice Quality Standard, Trusted Standard, Museum Accreditation.  Please list any governance toolkits the organisation uses such as the Club Matters Health Check. Please explain how your proposal is culturally appropriate for the groups you are intending to reach.  
See Help Notes Q7

8.	How and where will you promote and publicise your activity? 

See Help Notes Q8

9.	Will this activity take place entirely within the Cambridge City area? 

Yes/no 
If no, please give details
See Help Notes Q9

Beneficiaries 

10.	Beneficiaries - who is the activity for?   
Please let us know who will benefit from your activity – where they live (Table 1) and their age range (Table 2).  We want to know the direct beneficiaries, those actively participating in your activity and not the indirect beneficiaries such as audiences, indirect beneficiaries can be covered in Table 3.  See Help Notes Q10

Table 2 - Age range of the direct beneficiaries detailed in Table 1	
	Estimated number	
	All beneficiaries	City only beneficiaries	
Under 5s			
5-17			
18-25			
26-39			
40-59			
60 and over			
Total B			
Total A			

Total A should be the same figure in each table
Total B should be the same figure in each table	
   
Table 1 - Geographical area – where do the direct beneficiaries live?	
	Estimated number	% of total	
Cambridge City 
(the 14 City wards within the City boundary) 			
Total A			
South Cambs 
(for example  Girton, Milton, Histon, Waterbeach, Orchard Park, Cambourne, Haslingfield)			
Other parts of Cambridgeshire			
Other parts of the UK			
Total B – Total number of beneficiaries (including Total A)		100%	

Table 3 – Indirect beneficiaries
	
Please tell us about any indirect beneficiaries of your activity, such as audiences or parents of children attending funded sessions.

11.	Please let us know who will benefit from your activity? For example, refugees from Ukraine, refugees from another country (please specify), hosts, families, adults, children and young people, older people, LGBTQ+, people with disabilities, minoritised people, low-income families and individuals.

   See Help Notes Q11   Please state who:

12. If you are holding sessions, what do you expect the average attendance to be?

See Help Notes Q12

13. Please detail how you will engage (reach/enrol) beneficiaries in your project. 
See Help Notes Q13

14. You will need to monitor actual direct beneficiary numbers, and evidence how many are City residents fleeing the war in Ukraine.  How will you monitor the actual direct beneficiaries of your activity (number, 
       age range and where they live)?  

See Help Notes Q14

15. What safeguarding measures will be implemented to protect the safety and wellbeing of vulnerable groups (such as young people) benefiting from the proposed activity?
See Help Notes Q15

Outcomes and Impact

All applications must demonstrate how their activity meets one or more of the United with Ukraine funding priorities. This is an outcomes focussed grant fund and clear information on outcomes is critical to the assessment process.

16.  Why is this activity needed and what evidence do you have to support this need? (Maximum 500 words)

See Help Notes Q16

17. How will your activity/activities meet one or more of the United with Ukraine funding priorities? (Maximum 300 words)

See Help Notes Q17

18. Please tell us what difference you think this activity will make to the refugees fleeing the war in Ukraine. Please list all outcomes you hope to achieve. (Maximum 300 words)

See Help Notes Q18

19. How will you be able to evidence that your activity meets its outcomes outlined in Q18 above? 
How will you measure and evidence you have made a difference?  (Maximum 300 words)

See Help Notes Q19

20. Please tell us about what you feel the legacy of your project/activity will be? 
What will have been the overall impact on beneficiaries, your organisation, the groups you work with? 

See Help Notes Q20

Finance

Your budget for this activity

This section is to give a broad picture of the finances for the activity you are applying for. 
It is not a substitute for the more detailed whole organisation budget, which you need to submit as a supporting document with your application. 
As part of our monitoring, we may ask for copies of receipts as evidence of expenditure of the activity applied for.  We will expect them to relate to the information detailed below.

21. Expenditure - outline the main costs of this activity, making sure they match the figures in your whole organisation budget which needs to be submitted with your application.  Insert extra rows as required. We want to understand actual costs so please do not include ’in kind’ support/contributions – these can be detailed in question 24. See Help Notes Q21

Expense or Cost   such as hall hire for 3 days @ £70 a day, the hourly rate of paid staff	 Amount   £	Please put a X against expense you wish this grant to contribute to	

			

			

			
			
Total expenditure for the activity (full cost)		£		

22. Income - list all sources of income for this activity, with amounts.  Insert extra rows as required.  
Do not include “in kind” support/contributions. Please ensure you tell us what other sources of funding you have applied for and state if they have been successful. If your bid has not been successful, please indicate it in the Confirmed column by saying Nil award. See Help Notes Q22

Funding Source	Decision Date	Confirmed Yes/No/Nil award	 Amount £	
Eligible reserves carried forward from your organisation				
User contributions/session fees specific to this activity				
Donations specific to this activity				
Ticket sales specific for this activity				
Business sponsorship for this activity				
Other funders (insert a row for each)				

				
Cambridge City Council – United with Ukraine grant		No		£	
Total income for the activity (anticipated)	£

23.  How much are you requesting from Cambridge City Council and what percentage is this of the total cost of the activity?  See Help Notes Q23

Full cost of activity	Amount requested from Cambridge City Council 	% of the full cost requested from Cambridge City Council	
£ 	£	 %	

24.  Please provide any comments and/or calculations to evidence your activity is good value for money.

See Help Notes Q24

25.  How will you sustain your organisation and this activity into the future?  See Help Notes Q25

Your organisation	Activity you are applying for	

	How will the proposed project be sustained after the end of the funding period?

26.  Does funding from the United with Ukraine grant fund help you to obtain funding from other sources?  
If so, how much and where from?

See Help Notes Q26

Your Organisation

27.  We can see your aims from your constitution / governing document. Briefly describe what your organisation does.  This is in general and not just the activities you want funding for (Maximum 100 words)

See Help Notes Q27

28. How will you ensure that your work is coordinated with, and complementary to, the work carried out by other organisations? In particular, please refer to how you work with other  community organisations and other service providers, including local authorities.

See Help Notes Q28

29. How do you ensure that your team (staff and volunteers) are well trained, managed, and supported to do their jobs effectively? 

See Help Notes Q29

30. Please provide details of all employees, freelancers (and voluntary workers) that will be working on the project and providing funded activities. (Add rows as necessary)

Position/role	Funded activity/activities this role supports	Annual cost of contract/salary including employer’s overheads such as National Insurance, occupational pension where appropriate	% to be funded from this grant	
		£		

				

31.  It is essential that financial need for this grant can be evidenced clearly. Please insert the amounts from your latest annual accounts. See Help Notes Q31 + Appendix A for definitions

What was the year end date of your organisation’s most recent annual accounts? 	Please enter: DD/MM/YY

Income: 
£ 	Expenditure: 
£	Balance carried forward:
£	
Restricted Reserves: 
£	Unrestricted Designated Reserves:
£	Unrestricted General Reserves:
£	

32.  You are required to send us a copy of your reserves policy with your application. If your reserves are more than your reserves policy state you need, what are they for?  

See Help Notes Q32

33.  Please complete the following information relating to your organisation. See Help Notes Q33

Organisation name       
(as on your constitution / governing document)		
Is there any other working name for your organisation?		
Organisation address  
(office or main venue for your activities, if none leave blank)	 	
Organisation telephone number		
Organisation email address		
Organisation website address		
Contact name
(for all correspondence relating to this grant)		
Position in the organisation		
Contact address		
Contact telephone number		
Contact email address		
Trustee/Board member contact name		
Trustee/Board member contact email address		
Legal structure of your organisation (unincorporated association, charity, company limited by guarantee,  Community Amateur Sport Club, CIC, CIO etc)		
Registered charity number		
Company registration number		
Date your organisation was established		
Geographical area covered by your organisation (according to your constitution)		
Number of paid staff employed
http://www.hmrc.gov.uk/employment-status/index.htm	Full time:		Part time:		
Number of self-employed staff	Full time: 		Part time:
		
If you have paid staff, do you pay the Real Living Wage?  See Help Note Q33	Yes:		No:		
Number of volunteers	Trustees/
Board:		All others:		
Number of members, if you are a membership organisation		
How often does your board of trustees/directors/management committee meet?		

Organisation Eligibility Check See Help Notes

Complete every box next to each statement in the table below with one of the following: 

ü  	copy and paste the tick ü if the statement is true	
X 	put X if the statement is not true – this could mean your organisation is not eligible to apply	
NA	put NA if not applicable to your organisation	

ü	The organisation applying for this funding acknowledges the information in the application documents and confirms the organisation:	

GOVERNANCE
	
	is independently set up for charitable, benevolent or philanthropic purposes and does not operate for private, commercial or personal profit/gain	
	is not a statutory organisation or was not set up by a statutory organisation, or is not managed wholly or partly by a statutory organisation	
	has a legal structure that is appropriate to the size and nature of the organisation, with a governing document, for example, constitution, memorandum of association or set of rules, which sets out the aims and rules governing the organisation  	
	decides policy and overall management practice through a committee of a minimum of 3 unrelated, elected, unpaid volunteers (by unrelated we mean people who aren’t family members, such as siblings, parents and children; married couples or civil partners; or people living at the same address)	
	has systems and structures in place to manage the affairs of the organisation efficiently and effectively, for example, holds regular, quorate meetings, plans and monitors activities, keeps minutes and circulates information to group members	
	involves members and users in policymaking, service planning and in management, where appropriate	
	researches and meets the needs of local people and is able to demonstrate or evidence why this activity or service is required	
	complies with all statutory and legal responsibilities applicable to our organisation and its regulatory body 	
	meets the legal responsibilities of an employer and adopts, implements, and monitors good employment practices and procedures 	
	recruits and supports volunteers	
	has up to date, appropriate and adequate insurance cover 	
	demonstrates good governance and management by having policies and procedures for the following which are adopted, implemented, monitored and reviewed and comply with legislation	
	a)	Health and Safety - covering staff, volunteers and users, and includes risk assessments appropriate to activities	
	b)	Safeguarding - child and/or adult protection	
	c)	Equality & Diversity	
	d)	Environmental - reducing carbon footprint, energy efficiency, reducing waste, and increasing recycling 	
	e)	Confidentiality / Data Protection (GDPR)	
	f)	Complaints	
	g)	Disclosure and barring service (DBS) checks for all paid and unpaid volunteer staff working with children and vulnerable adults	

FINANCES
See Appendix A on Application Help Notes 
	
	demonstrates good financial management and sustainability by:	
	a)	keeping proper and adequate financial records to explain all transactions, the organisation’s financial position and audit trails of decisions made	
	b)	preparing statutory accounts meeting legal requirements and complying with any external scrutiny required by law or the organisation’s governing document	
	c)	preparing budgets and monitoring them at least quarterly and preparing revised financial forecasts based on actual spend	
	d)	presenting regular reports on the organisation’s financial position to the management committee	
	e)	preparing a reserves policy detailing the level of reserves held and an explanation and calculation of why they are held and update this annually	
	f)	ensuring that effective financial systems and procedures have been established, are being consistently followed and are in line with best practice and legal requirements 	
	g)	reviewing internal financial controls to ensure they are adequate and being complied with to provide a robust system for managing financial risk. Ensure all expenditure has dual authorisation and documented accordingly, including but not limited to cheques, purchase orders, invoices, receipts and electronic transactions. For on-line transactions and debit card payments the Recipient will keep a written record evidencing the transactions	
	h)	not being reliant on Cambridge City Council funding alone 	
	charges users at a reasonable level and offers concessionary rates to low-income residents	
	can demonstrate they need financial support for the activity and do not have free reserves that could be used for this purpose	
	applies to all relevant statutory agencies for funding and undertakes their own fundraising  	
	has used previous City Council grants for the purpose awarded and reported these as restricted funds in accounts	
WORKING WITH REFUGEES
	
	has experience of delivering activities funded by a United with Ukraine (UwU) grant, or a good track record of working with refugees and asylum seekers in the UK	
	can demonstrate connections to refugees fleeing the war in Ukraine who reside in Cambridge, or to local organisations supporting refugees from Ukraine who reside in Cambridge 	

GENERAL
	
	does not promote any political parties, is not involved in party politics, or does not promote political views	
	will provide any information required to support their application	
	has returned satisfactory monitoring and evaluation, accounts or other information requested in connection with any previous funding from the Council on time	

Application Documents see Help Notes

Your application cannot be considered for funding if any of the application documents are missing	

The documents listed below must be submitted with this application form. Copy and paste the tick ü to indicate you have done this.

It is good practice to ensure that all policies are dated and are regularly reviewed. 

Documents to be submitted with your application	Year ended or 
date adopted	Attached
ü	
Latest set of annual accounts			
Updated, full organisation budget for your current financial year 			
Full organisation budget for your next financial year 			
Copy of bank statement covering the period of your year end - please send a legible photocopy, scan or screenshot			
Latest Reserves Policy see Help Notes			
Annual Report / latest report of activities			
Governing document / constitution or rules			
Appropriate insurance – please send a legible photocopy, scan or screenshot			
Health & Safety Policy				
Safeguarding - child and/or adult protection			
Equality & Diversity Policy			
Environmental Policy			
Confidentiality / Data Protection (GDPR) Policy 			
Complaints Policy 			
A list of your Committee / Board Members or Trustees 			

Declaration

I am the contact named in Question 33 above and I am authorised to sign this on behalf of the organisation.  I confirm on behalf of the organisation that we:
a)	state that all answers to the questions on this form are correct to the best of our knowledge
b)	have read and agree to be bound by the funding information provided by Cambridge City Council in the application documents and will ensure that all the organisation’s management committee and/or staff and relevant volunteers are aware of their contents
c)	undertake that any funding made available by the Council, or such part of it as the Council may determine, shall be repaid if the organisation:
i.	is found to be in breach of the conditions that apply to the funding 
ii.	does not spend the grant on the purpose allocated
iii.	becomes insolvent or closes down
d)	understand that, as the grant comes from public funds, we must inform you of any surplus made from the activity and you reserve the right to require us to pay back all or part of the grant
e)	understand that this grant will not be used in any way to promote a political or religious organisation or to generate private gain. The organisation will also take care to avoid giving the impression that it supports any political party or candidate in an election and will not give publicity to political parties or to individual politicians or candidates in the six-week period leading to an election
f)	understand that special conditions may be attached to the award of any funding and that Cambridge City Council will require information for monitoring and evaluation purposes
g)	acknowledge there is no commitment by the Council to continue funding after that period is over or to sustain a grant at the same level as that of a previous year

Full name of Group / Organisation 		
Signed for and on behalf of above Group / Organisation (please add your electronic signature or type your name)		
Name and position in Group / Organisation		
Date		

Please tick here if you would like to be contacted about other:

grant funding opportunities 

general information relevant to your group

Submitting your application – important information

Please check that you have:
•	answered all the questions on this form
•	collected and attached all the supporting documents required 
•	signed the form appropriately

Email the completed form with all the supporting application documents specified to:  grants@cambridge.gov.uk