<p> European Social Fund Social Economy Growth Fund Round 2</p><p>APPLICATION FORM</p><p>Organisation Project Title</p><p>Page 1 of 17 PURPOSE</p><p>The Social Economy Growth Fund will support and grow the capacity of Scotland’s social economy organisations to increase and improve services for people experiencing poverty and disadvantage. Priority will be given to organisations that have a proven track record in supporting homeless people and workless, low income or single parent households, all of whom may face additional barriers. All activity must take place in Scotland.</p><p>WHO CAN APPLY?</p><p>Eligible applicants can be constituted social economy organisations, including social enterprises, who operate in Scotland. We will only support organisations that are solvent and are in a position to continue to successfully deliver service in the longer term. Please refer to the Eligibility section of the accompanying Guidance Note for further details. </p><p>APPLICATION PROCESS </p><p>Prior to completing your application please ensure that you have read and understood the guidance. We would encourage applicants with any queries in relation to the Fund to email [email protected].</p><p>Applications and all supporting documentation must be submitted by 5pm on the deadline date to [email protected]. Please forward 2 certified hard copies of the application form no later than 3 working days after the deadline.</p><p>2 Section 1: Applicant Details</p><p>Applicant Details</p><p>Name of Organisation</p><p>Applicant Legal Status</p><p>Incorporated Body</p><p>Organisation Type</p><p>Registered Company Number</p><p>Registered Charity Number If your organisation is a subsidiary of or affiliated to a parent company, please provide details Establishment date of your organisation Organisation has UK bank account, published accounts and control over expenditure VAT Registration Number</p><p>Is your organisation able to reclaim all VAT If you are unable to reclaim all VAT what is the % of VAT you can reclaim</p><p>Contact Details for Correspondence</p><p>Main contact Job title/designation</p><p>Full address, including postcode</p><p>Telephone Email Website</p><p>Page 3 of 17 Section 2: About your Organisation</p><p>Please describe the current activities delivered by your organisation and how these are supported. (max 500 words)</p><p>4 Please demonstrate that there are robust systems and suitably experienced staff in place to manage the project and comply with ESF requirements. (max 500 words)</p><p>Page 5 of 17 How many staff do you employ? Full-time: Part-time: Volunteers:</p><p>Do you have an Equality and Diversity Policy? Yes No </p><p>Do you have an Environmental Policy? Yes No </p><p>Section 3: Project description and objectives</p><p>Please state the proposed start and end dates of your project. Start date: End date:</p><p>In which Local Authority area(s) will your project take place?</p><p>Aberdeen Edinburgh Orkney Islands Aberdeenshire Falkirk Perth and Kinross Angus Fife Renfrewshire Argyll & Bute Glasgow Scottish Borders Clackmannanshire Highland Shetland Islands Dumfries & Galloway Inverclyde South Ayrshire Dundee Moray South Lanarkshire East Ayrshire Midlothian Stirling East Dunbartonshire Nan Eilean Siar West Dunbartonshire East Lothian North Ayrshire West Lothian East Renfrewshire North Lanarkshire </p><p>Please tell us about your project proposal and all planned activity. (max 800 words)</p><p>6 Page 7 of 17 Please describe your project rationale and strategic fit. (max 500 words)</p><p>8 Please tell us about your project’s objectives and outcomes. (max 500 words)</p><p>Page 9 of 17 10 Please describe the ‘added value’ of your project, and explain why ESF grant assistance is needed to enable it to proceed. (max 500 words)</p><p>Page 11 of 17 12 How will you ensure your project addresses the Horizontal Themes of Equal Opportunities, Environmental Sustainability and Social Inclusion? (max 500 words)</p><p>Page 13 of 17 Please state how European Social Fund and Scottish Government support will be acknowledged. (max 250 words)</p><p>Please explain how you will sustain the project activity beyond the end of the funding period. (max 250 words)</p><p>14 Section 4: Financial Information</p><p>Please complete the financial annex and transfer the figures into the tables below.</p><p>Expenditure 2018 2019 2020 Total (£) a) Total Eligible Project Cost b) Total Ineligible Project Cost c) Total Project Cost</p><p>Please provide details of all other funding providers for your project (if applicable)</p><p>Eligible / Year Confirmed Value (£) Match Funder Non Eligible Date</p><p>Please provide details of income generation as a result of your project (if applicable)</p><p>Income Description Year Value (£)</p><p>Please provide figures from your latest approved accounts. Accounting year ending (dd/mm/yyyy) Total income for the year Total expenditure for the year Surplus or deficit at year end Total savings or reserves at year end</p><p>Have you considered the 4 State Aid test questions referred to in Yes No the Guidance Notes?</p><p>If you answered yes to any State Aid questions please provide information below</p><p>Have you received any de minimis aid in the last 3 fiscal years? Yes No </p><p>If yes, please provide details</p><p>Page 15 of 17 Section 5: Declaration</p><p>By signing this declaration you are confirming that you are an authorised signatory for the social economy organisation applying to the Social Economy Growth Fund. You are also confirming that the statement below is accurate.</p><p>As far as we know and believe, all of the information in this application form is true, accurate and complete. We are authorised to allow this proposal to go ahead. We are happy for the Scottish Government to:</p><p> publish details of the financial support they are giving to this proposal;  give any details they have about our proposal from this application or from future assessments to Scottish Government colleagues, other agencies, including other grant-making bodies; and  use any of these details in news releases, case studies, publications and other publicity materials.</p><p>The Scottish Government can do these things without asking us again for our agreement and will not use any of these details for commercial purposes.</p><p>16 Authorised Signatory Details Full Name:</p><p>Designation in Applicant Organisation:</p><p>Contact address:</p><p>Telephone: Email:</p><p>Signed:</p><p>Date:</p><p>Page 17 of 17</p>