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. How many houses in your housing estate? 2. Is your housing estate a local authority or private estate? 3. Is there a management company in your estate? 4. How many houses are active on your Residents Association? 5. Does every house in your housing estate have a working smoke alarm? Yes 6. Private Local Authority No How many housing units for older persons are in your estate? 7. Do you include these tenants/residents in your association and does your overall programme include these OPD (Older Person Dwelling) areas? Please give a brief description: 8. How many houses contribute to your fundraising efforts? 9. How many meetings do you hold per year? 10. Is at least one meeting open to all residents? Yes No 11. Do you receive support from a local Community Employment Scheme (FÁS)? Yes No Do you have any contact with your local Tidy Towns Group? Yes No If No, would you be willing to co-operate with your Tidy Towns group, if initial contact is established? Yes No Have you received grant assistance in previous years? Yes No 12. 13. 14. If yes, please state most recent 15. Briefly describe your fundraising programme 16. Briefly describe your on-going work programme 17. Briefly describe any new projects / activities planned for 2015 18. What work, if any, is carried out by the Community Employment Scheme (FÁS)? 19. What work is carried out by voluntary effort? 20. Approximately how much will the delivery of your planned work programme cost in 2015? _____ 21. Briefly describe your Litter Management Programme. 22. Is /has your group participated in National Spring Clean 2015? 23. Yes 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 the 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: housingenvaware@louthcoco.ie 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:
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