Green Shoots Example form – Contact Name Jan Smith Organisation Friends of Council Offices Delivery Address for bulbs, including post code 221b Baker Street Coalville Leicestershire LE67 XYZ Email address Jan.smith@gmail.com Daytime Telephone Number 0787 777777 Total number of bulbs requested, in multiples of 1000 2000 Number of bulbs per variety 1000 Narcissi Daffodils 1000 Crocus 0 0 English bluebells Other species 0 Please note that we will try to accommodate your request but this will be dependent on cost How much cash match funding are you contributing? £100 This can be from your own organisation and/or from a sponsor or other funder. Please note, another NWLDC grant cannot be used for match funding. What is the total value of your project? Green Shoots grant £100 NWLDC grant + cash contribution + volunteer Our contribution £100 contribution Other sponsorship/funding £0 In-kind contribution £450 ______ £650 Volunteer contribution Please include any volunteer time used to help plant the (3hrs x 15 people x £10 per hour = £450) bulbs, calculated at £10 per hour per person. Approximate number of people likely to be involved 15 volunteers, aged 3- 70 yrs in your project How will your project benefit the local community? We are inviting local residents to get involved in the planting, bringing the community together. When the bulbs flower in spring they will help attract insects and create a colourful welcome to residents and visitors alike. Where will your project take place? North West Leicestershire District Council Please provide an address for the site(s) you are offices, Whitwick Road, Coalville, LE67 3FJ considering and ideally a if you can. SK428143 Map of area where your project will take place See location map at bottom of form. Indication on a google map is sufficient. If you are not
Green Shoots – Example form Contact Name Jan Smith Organisation Friends of Council Offices Delivery Address for bulbs, including post code 221b Baker Street Coalville Leicestershire LE67 XYZ Email address Jan.smith@gmail.com Daytime Telephone Number 0787 777777 Total number of bulbs requested, in multiples of 1000 2000 Number of bulbs per variety Narcissi 1000 Daffodils 1000 Crocus 0 English bluebells 0 Other species Please note that we will try to accommodate your request but this will be dependent on cost 0 How much cash match funding are you contributing? This can be from your own organisation and/or from a sponsor or other funder. Please note, another NWLDC grant cannot be used for match funding. £100 What is the total value of your project? NWLDC grant + cash contribution + volunteer contribution Please include any volunteer time used to help plant the bulbs, calculated at £10 per hour per person. Green Shoots grant £100 Our contribution £100 Other sponsorship/funding £0 In-kind contribution £450 ______ £650 Volunteer contribution (3hrs x 15 people x £10 per hour = £450) Approximate number of people likely to be involved in your project 15 volunteers, aged 3- 70 yrs How will your project benefit the local community? We are inviting local residents to get involved in the planting, bringing the community together. When the bulbs flower in spring they will help attract insects and create a colourful welcome to residents and visitors alike. Where will your project take place? Please provide an address for the site(s) you are considering and ideally a if you can. North West Leicestershire District Council offices, Whitwick Road, Coalville, LE67 3FJ SK428143 Map of area where your project will take place Indication on a google map is sufficient. If you are not See location map at bottom of form.
Green%20Shoots%20example%20form%202015.docx