BACKGROUND INFORMATION

Louth & Meath Education & Training Board

Community Education Service

Application for Grant AssistanceSUMMER 2014

Please fill in all sections of this form and return no later than Wednesday 30th April to either of the following:

Shauna Doherty Sinéad Fearon Community Education Facilitator Community Education FacilitatorLMETB LMETBAlpha Learning Centre Chapel Street Abbey Road, Navan DundalkCo. Meath Co. Louth

Or e-mail completed form to sdoherty@lmetb.ie or sfearon@lmetb.ie(If you require a Word version of this document please contact us by e-mail)

Name of Community Group

Aims and Objectives of Group/Service

Date group was established

Number of members in group

Male Female

Previous or current work of your group in the following areas: Education/ Training/ Community Development

Reference Code Office Use Only:

Where do the group meet:

Name and address of contact person

Contact number

Contact e-mail address

If the group have a website or facebook/twitter account, please provide details here

Target Group (Please tick the category that applies to your group – in particular the participants who will be taking part in the programme for which you are seeking funding)

Person With a Disability TravellerSubstance Misuser HomelessEx-Offender RefugeeEarly School Leaver Asylum SeekerOne-Parent Family Migrant WorkerCommunity Based Women’s Grp Community Arts GroupOlder Person’s Group Community VolunteerRural Men’s Group Rural Women’s GroupLong Term Unemployed Underemployed

Sessional/Seasonal WorkersOther – Please Specify

FUNDING INFORMATION

Has the group received funding before from Louth or Meath VEC?

Yes No If yes, please supply the following detailsYear Amount Course Service which provided the

funding (e.g. Community Education, Youth Office etc.)

Has the group received any other funding this year from other sources?

Yes No

Year Amount Course Service/Organisation which provided the funding

2013

2013

2013

Has the group received funding from other sources towards this proposed course?

Yes No

If yes, please supply the following detailsFunding Given by Amount

Title of the course/project you are seeking funding for:

Topics/ subjects areas which you would like the course to cover:

Will certification be offered to the participants?

Yes No

If yes please state Level and also the certifying body e.g. FETAC, Red Cross, ECDL etc.

Purpose for which the grant application is made:

Financial support towards tuition costs for the course(this is where the group organise payment of their own tutor using the grant received)

Tuition Hours (ETB to supply the tutor) (this is where the ETB organise and pay the tutor directly)

Use of ETB PremisesPlease outline the overall aim and expected outcomes of the course/project

State how the proposed course/project aims to address the following issues and also how it will contribute to improving the quality of life of the individual and/or the local community

Target educational and social disadvantage Promote social inclusion Foster personal development and skills enhancement for group members Widen participation in learning by adults from all sectors of our community

SPECIFIC COURSE DETAILS

How will members of the community be recruited for the course/project:

Do you agree to tell participants that the funding is from Louth & Meath Education and Training Board?Yes No

Please outline any plans you may have for your group over 2014 in terms of progression/ development/ further funding you may be seeking.

Proposed Location of Course – please give venue and location

Proposed Number of Participants Male Female

Estimated Number of Participants by Age(please remember this funding is for over 18 only) 18 – 20 21 – 24

25 – 34 35 – 44

45 – 54 55 – 64

65+

Duration of Course in Hours

Duration of Course in Weeks

Proposed Start Date/Month

If using your own tutor please supply Name

COURSE COSTINGS

of tutor & qualification (if already identified).(If using more than one tutor please give details of each)

Please choose which option you wish to apply for and fill in the requested details.

If you are looking for a financial grant from LMETB please tick this box. You must provide the overall cost for the programme in the section below, including other costs not being sought from LMETB. Leave blank any sections which are not applicable.

If you are looking for Tuition Hours from LMETB please tick this box. Please fill in the section below. You may leave the tuition section blank but you must fill in other costs/income associated with the running of the course that are not being requested from LMETB

If you are only looking for use of LMETB premises please tick this box. Do not fill in the section below.

Tuition (cost per hour)

MaterialsAdministrationOverheadsOther – Please Specify

Total Estimated CostIncome from other sources e.g. other agencies, fee from participants etc. – Please Specify

Total Grant Sought in 2014 from Community Education

Signed on behalf of the group: _____________________________________

Position in group: _____________________________________

Date: _____________________________________

If you have any queries on any aspect of the application form, please contact either of the following:

Sinéad Fearon 042 9364627    sfearon@lmetb.ie

or

Shauna Doherty 046 9068247  sdoherty@lmetb.ie