1.
COMMUNITY AND ENTERPRISE DEPARTMENT
COMMUNITY GRANT APPLICATION FORM 2011
Closing Date 31st January 2011
Date Received:-
Reference Number:-
ALL APPLICATIONS ARE TO BE MADE TO:
The Office of the Director of Community and Enterprise
Block 4, Floor 1e
Civic Offices, Wood Quay.
Dublin 8
By 5pm 31st January 2011.

2.
2
SECTION 1 – GROUP/ ORGANISATION DETAILS
Name of Organisation __________________________________________________________
Address __________________________________________________________
__________________________________________________________
Postal District __________________________________________________________
Tax Clearance Cert/Charity Status Number (if applicable) : ___________________________
Expiry Date: __________________
Is your Organisation affiliated to the Dublin Community Forum? Yes / No
( Please circle which is appropriate)
Contact Name __________________________________________________________
Telephone No. ___________________________________
E-mail ___________________________________
Bank Details of Organisation
Account Name ____________________________________________________________________
Bank Address ____________________________________________________________________
Sort Code
____________________________________________________________________
Account Number ___________________________________________________________________

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COMMUNITY GRANT APPLICATION FORM
SECTION 2 - PURPOSE OF GRANT
Note: The City Council will support community activities at neighbourhood level promoted by voluntary
groups eg. festivals, environmental activities, older persons activities, heritage/historical projects etc.
The City Council under its Community Grants Scheme will not support sports activities eg. football clubs nor
will it provide funding for the employment of staff. For further advice and information please discuss your
proposal with your local community development staff member.
What is the purpose of the Grant?
___________________________________________________________________________________
Who is going to participate in this project and how many participants will be involved?
___________________________________________________________________________________
Where will this project take place?
___________________________________________________________________________________
___________________________________________________________________________________
Commencement Date ____________________ Completion Date__________________________
Description of the Activity
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

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COMMUNITY GRANT APPLICATION FORM
SECTION 3 - FUNDING
How much is the overall cost of the project? _________________________________
How much is being applied for under the DCC Community Grants Scheme?
_____________________________________
Please provide details of other funding already received for the project/event:
Name of Organisation: _______________________________________________________
Amount Received: _______________________________________________________
Date Received: _______________________________________________________
Please provide details of potential income:
Name of Organisation: ________________________________________________________
Amount: ________________________________________________________
SECTION 4 - DECLARATION
DECLARATION
I declare that the information supplied is accurate and complete.
I understand that all information provided in respect of the Grant Application will be held
electronically and may be made available to other Dublin City Council Departments as
appropriate.
It should be noted that the Freedom of Information Act applies to all records held by Dublin City
Council. (The application must be signed by either the Chairperson, Secretary or Treasurer of the
organisation making the submission).
Name (please print) ___________________________ Date ________________________
Signed ______________________ Chairperson/Secretary/ Treasurer (delete as appropriate)