Liverpool City Council

Your organisation

Full name

Full registered name of organisation

Registered office address If your address is outside Liverpool, click "please enter it manually" and then enter your address and postcode.

Postcode

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

Contact number

Email address

Companies House registration number - optional (if applicable)

Registered charity number - optional (if applicable)

Declaration of Interest Provide details of any Liverpool City Council (LCC) employee or councillor who undertakes an official role or has a financial interest in your organisation.

Name of employee or councillor - optional

Their role in LCC - optional

Their role in your organisation - optional

Add declaration of interest

Project details

Project name

Project start date

Project end date

Will your project involve any partnership working?

Funding requested

Total funding requested (£)

Will the total cost of this project be funded by the Domestic Abuse Support within Safe Accommodation Small Grants?

No
Yes

Please tell us how you plan to fund the remaining cost of the project, including details of other funders, and include any sources of income. Be as specific as possible, for example "LCC Community Resource Grant" or "Rental income". You can include expected sources of funding and/or income, but you must make this clear in the table. (To add another item, click 'Add')

Description of funding stream or source of income

Date secured or expected

Amount (£)

Add funding stream or source of income

Finance

Please provide a proposed budget for your project below and indicate the amount requested from the Domestic Abuse Support within Safe Accommodation Small Grants Programme. To add details of another funding item, click 'Add item'.

Item description

Cost (£)

Add item

Project overview

Provide a detailed overview of the project, how it will be delivered and the timeframe for delivery. What is the identified need your project will tackle and how? If you are working with other organisations to deliver your project, include who you are working with and what their role on the project will be. Your answer must demonstrate how your project is within the remit of ‘domestic abuse support within relevant safe accommodation’ as per the Domestic Abuse Act 2021 - Part 4. Your answer must also demonstrate how your project will meet the ambitions within Liverpool’s Safe Accommodation Strategy. Please refer to grant specification document for detail and further information. (Max. 750 words)

Outcomes

Provide a minimum of 2 outcomes for the project. These outcomes should be specific, measurable and time limited. Include the estimated number of people who will benefit from your project both directly and in-directly? The outcomes are the achievements and the end results of your activity, not just the number of people you work with. (Max. 500 words)

Experience and skills

Provide clear examples / evidence of your organisation's capacity, experience and skills, which demonstrate that the organisation has the ability to deliver on all of the outcomes (in questions 1 and 2) that you are seeking to achieve. (Max. 500 words)

Equality and Inclusion

Provide a clear and detailed plan of how your organisation will support those with Protected Characteristics and those with additional and / or complex needs. Include details of any specialist support for victims and survivors. Will your project be inclusive of everyone? If there are groups which will be excluded from accessing your project / support, please provide details and rationale for the exclusion. Refer to the Grant Specification Document for the definition of specialist support (include if your service is ‘by and for’). (Max. 500 words)

Assessment and Reporting

Provide details of how you will monitor and evaluate your success, achievements and outcomes. Examples may include a range of pre / post self-assessment tools, case studies, authorised photographs, service user statements or quotes. You will be required to complete a monitoring and beneficiary form on delivery of the project, if successful (Max. 500 words)

Social Value

Please detail the wider social, economic, and environmental benefits of the project (maximum 500 words)

Carbon Footprint

Please detail the steps your organisation has taken or will take to minimise the carbon footprint of the organisation in general and this project in particular (maximum 500 words)

Confirmation

Your name

Your email address

Declaration

On behalf of the organisation, I confirm that the information provided in this grant application is true and accurate and that I am authorised to submit it. I understand your obligation under General Data Protection Regulation (GDPR), the Data Protection Act 2018 and the Freedom of Information Act 2000.

Position within organisation

Will you also manage the grant if this application is successful?

Yes
No

Name of person who will manage the grant

Email address of person who will manage the grant

Before you submit this form please review your answers below. If you need to change anything, use the 'previous' button on the bottom left to go back to a section. Then submit the form by selecting the 'Submit button' at the bottom of this page