Name of Organisation: Secretary / Contact Person: Correspondence Address: Contact No Email Current Tax Number (Failure to provide current tax number will result in non-payment of grant) 1. Have you received grant assistance in previous years? Yes If so please state the most recent 2. Approx. how many volunteers do you have: (a) On your actual Committee (b) Participating in your work programme 3. Briefly describe your on-going work programme 4. Briefly describe any new projects / activities planned for 2015 No ________________ 5. Briefly describe, if applicable, your partnership with your local Tidy Towns 6. Briefly describe Waste Management/Recycling activities undertaken by your organisation. 7. Briefly describe your fundraising programme: ________________ 8. Approximately how much will the delivery of your planned work programme cost in 2015? € 9. Briefly describe your Litter Management Programme. 10. Will your group be participating in National Spring Clean 2015? Yes 11. Do you undertake to ensure that all projects receiving funding under the Louth County Council Amenity Grant Scheme will be maintained in future years? Yes No No Groups availing of funding under this Scheme will be required to register with County Louth Public Participation Network (PPN), a group which provides a representative voice for the community sector in Louth and shares relevant information and experience with its members. Visit www.louthppn.ie for details. Chairperson Secretary (BLOCK CAPITALS) (BLOCK CAPITALS) (Signature) (Signature) Date THE CLOSING DATE FOR RECEIPT OF COMPLETED APPLICATION FORMS IS: FRIDAY 24TH APRIL 2015 COMPLETED APPLICATION FORMS SHOULD BE ADDRESSED TO: SOCIAL & COMMUNITY SECTION LOUTH COUNTY COUNCIL MILLENNIUM CENTRE DUNDALK CO. LOUTH PHONE: 042 9392918 EMAIL: [email protected] NB – LATE APPLICATIONS WILL NOT BE ACCEPTED Data Protection Information Please complete and return with your Application Form From time to time Louth County Council receives requests from Tidy Towns groups in other counties and/or suppliers of products (such as litter bins, public seating etc.) for contact details of Tidy Towns Groups/Residents Associations. Under Data Protection, Louth County Council cannot release this information without permission even though the information being shared is of mutual benefit. For future reference do you wish to have your contact details made available to other parties with an interest in Tidy Towns? Yes No If yes, please provide contact details of a representative you wish to make available - this can take the form of a postal address, personal email address, group email address etc. Name of Representative: Contact Details:
© Copyright 2024