The Executive OfficeYouth Intervention Programme

Application Form 2018/19

Please read the Guidance Notes before you fill in this form.

You must submit separate applications forms for each proposed Scheme.

Please answer each question in the box provided. No additional documentation will be considered. Please do not send any additional brochures or leaflets at this stage.

If an application is deemed incomplete it will be rejected.

Returning your application

Applications should be returned to the Education Authority.

Applications may be submitted by email or post by the closing date Friday 20 April 2018 at 2pm. (The signed original application form must be submitted before funding will be released). Applications should be returned to:

Jean MorninEducation AuthorityDundonald Offices

Grahamsbridge RoadDundonald

Belfast, BT16 0HS

Email Address:. sgp@eani.org.uk

Applications received after the closing date/time will not be considered.

Youth Intervention Programme 2018-19

Group contact DetailsGroup/Lead Organisation Name

Contact Name

Position

Address for Correspondence Post Code:

Telephone Number: Mobile:

Website Address:

Email Address:Assembly Constituency Area organisation is based in Framework Document pg 9.

Is your organisation registered with the Education Authority?

If your group is not registered with EA please provide Bank Account details. (Bank Account must have two signatories and be in the same name as the applicant group)Bank Account Name

Account Number

Sot Code

Name of Bank

Bank Address Post Code

Please list office bearers below and attach a copy of your constitution:

Chair – Name

Address

Post Code

Secretary– Name

Address

Post Code

Treasurer Name

Address

Post Code

What is the legal status of your organisation? (e.g. voluntary/community body with a constitution, limited company/company limited by guarantee with charitable status, registered charity etc).

Charity Registration Number (if applicable)

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Youth Intervention Programme 2018-19

Child Protection DeclarationNew guidance on the changes to Pre-Employment Checking and Safer Recruitment Practices for employers in Voluntary Youth Units and Schools were published by the Department of Education on 1st

October 2012. A copy of these can be viewed on:http://www.deni.gov.uk/disclosure_and_barring_arrangements_-_guidance_for_schools_and_employing_authorities_-_volunteers_-_english_version.pdf

Please read them and answer the following questions:Does your organisation have a child protection policy?(A copy should accompany your application)Does your Policy outline procedures for recruitment and criminal record background checks in line with the Department of Education regulations?STATEMENT OF ASSURANCE:

Our organisation is in compliance with the October 2012 Disclosure and Barring Procedures as described in the Department of Education guidance.

Signed: __________________________________ Chairperson

Groups are advised it is an offence to knowingly employ a person who has been disqualified from working with children

Do you hold current and appropriate insurance cover for your project including Public Liability and Employers Liability Insurance?

Yes/No

Is your organisation registered with Access NI? Yes/No

If yes, please provide:

Date of Registration

Access NI Registration Number

Name of Lead Signatory for Registration

ORRegistered with an umbrella body in order to obtain Access NI checks?If Yes please give name of umbrella body

ORIf the organisation is not registered in either case above, please provide a statement detailing why this is the case

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Youth Intervention Programme 2018-19

What is the name of your scheme?When will your scheme start? (day/month/year)When will your scheme end? (day/month/year)

Please provide details of all the organisations/groups involved in the project.For example, community & voluntary groups, schools, youth clubs, sporting organisations, faith-based, statutory (e.g. PSNI, Council, Health Trusts) and the role that they will play (e.g. recruitment, facilitation/activities, information provision).You must also provide details of their involvement. A letter/letters of support must be enclosed with your application.Name of group/organisation and type of organisation

Contact details – Telephone number and email address

Their role in the project

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Youth Intervention Programme 2018-19

Youth Intervention Scheme OutcomesA number of set outcomes are required from the Youth Intervention Schemes, as illustrated in the Table below.

Youth Intervention Scheme Outcomes

Outcome 1Reduction in number of crime and antisocial behaviour incidents in the areas where

the young people live.

Outcome 2 Reduction in the number of young people engaging in risk taking behaviours.

Outcome 3Increase in the % of young people who think favourably about young people in the

other community.

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Youth Intervention Programme – Application Form 2018-19

1. Please describe the main activities that your scheme will undertake at to contribute to the Youth Intervention Scheme Outcomes. All Youth Intervention Programmes must demonstrate how they meet the criteria for funding and achieve the set outcomes.Intervention Scheme Outcome/s that your project will contribute to (as indicated on pg 5)

Activity, workshop, and or developmental group work descriptions

Exact dates and times of delivery and venue

Number of Face to face Hours

How much will you do?

How will you measure how well you have delivered your output?

Outcome of activity - is anyone better off as a result?

Example:

Outcome 1

Young people from Metropolis. Young people will draw up contract, take part in workshops on young people’s identity looking at different cultural backgrounds.Young People will take part in team building activities/ice breakers to assist in the development the group

Tuesday12th July 2016

1.00pm – 10.00pm

Metropolis Community Centre

9 hours 24 young people attending, 12 from each community

0r

24 young people attending from the Metropolis community

100% of young people completing the programme.

90% of young people who had not met anyone from other community

100% of young people who enjoyed the activity

100% of young people who have a better understanding of different identities.

100% of young people whose attitudes have improved towards young people with a different religious belief

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Example

Youth Intervention Programme – Application Form 2018/19

1. Please describe the main activities that your scheme will undertake at to contribute to the Youth Intervention Scheme Outcomes. All Youth Intervention Programmes must demonstrate how they meet the criteria for funding and achieve the set outcomes.Intervention Scheme Outcome/s that your project will contribute to (as indicated on pg 5)

Activity, workshop, and or developmental group work descriptions

Exact dates and times of delivery and venue

Number of Face to face Hours

How much will you do?

How will you measure how well you have delivered your output?

Outcome of activity - is anyone better off as a result?

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Youth Intervention Programme – Application Form 2018/19

Please provide numbers of young people and leaders involved in the project:Number of young people (i.e. Participants)

10-13 years old 14-16 years old 17-19 years old 19-25 years old Total Participants

Number of Project leaders and assistants

Paid (either by funding or directly from Employee)

VoluntaryUnder 25 years –leaders/assistants either in a paid or voluntary role

Total Programme leaders and assistants

Programmes can run on a cross community basis to include participants from both the CNR and PUL communities or single identity basis. However, we also encourage proposals which include participation from other communities including ethnic minority communities and those of different racial backgrounds. The programme must illustrate how it meets the criteria for funding and demonstrate how the set outcomes will be achieved.

2. How would you classify your target area (please tick only one)

Area/s not noted for sectarian activities/civil disorder

Area/s of recently identified sectarian activities/civil disorder

Area/s of high sectarian activities/civil disorder

Severely heightened sectarian activities/civil disorder /interface/hotspot

Please outline the evidence for your choice of classification

Please describe how your project will meet this criteria

Max 300 Words Word Count ____________

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Youth Intervention Programme – Application Form 2018/19

3. Please detail how you propose to identify/target specific beneficiaries i.e. those most at risk of becoming involved in sectarian activities, civil disorders and other crimes.

Please describe the methods you will use to identify/recruit young people and promote your project.

Max 300 Words Word Count ____________4. Highlight the developmental opportunities which may encourage behavioural or attitudinal change.

Please describe how your programme content and delivery will encourage change.

Max 300 Words Word Count ____________

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Youth Intervention Programme – Application Form 2018/19

5. Describe how the programme will engage young people who may otherwise become involvedin sectarian activities, civil disorders and other crimes.

Please describe how yourproject will meet this criteria

Max 300 Words Word Count ____________6. Please indicate how this programme proposal is additional to existing programmes provided by your organisation

Please describe how your programme will meet this criteria.

Max 300 Words Word Count ____________

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Youth Intervention Programme – Application Form 2018/19

7. Operational times - How will the proposed days and times of operation of your programmecontribute to the reduction of sectarian tension, civil disorder and other crime?

Please describe how your programme will meet this criteria?

Max 300 Words Word Count ____________8. What methods will you use to evaluate and measure the impact of the project with stakeholders? (e.g. questionnaires, letters of support, quotes, media articles etc)With young people

With staff, volunteers, programme partners

With parents and community representatives

With PSNI ( in relation to reduction in tensions/incidents) and other key stakeholders (e.g. emergency services

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Youth Intervention Programme – Application Form 2018/19

10. Proposed Programme/Project Costs: (subject to approval grant will normally beavailable in the areas detailed in the box below: (Use a continuation sheet if necessary)

ITEM SUPPLIER COST PER ITEM Total CostTransport

Entrance charges

Materials / equipment

Residential

Paid Leadership

Other

TOTAL COST £

Please give details of part-time leadership, artists, tutors or outdoor instructors for whom you

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9. Financial Support from Other Agencies in respect of this proposal:Has your organisation applied for support from other agencies?

If Yes, Please provide details below:

Yes ---------No

Agency Amount (£) Purpose

Youth Intervention Programme - Application Form 2018/19

are seeking grant-aid (Use a continuation sheet if necessary).

(NB: PLEASE READ CONDITIONS OF GRANT AND APPROVED RATES OF PAY IN THEFRAMEWORK DOCUMENT). The maximum rate per hour will not exceed £16.46 per hour

11. JOB TITLE TOTAL HOURS

RATE of PAY

DUTIES QUALIFICATIONS

12. Your project must represent value for money.If your programme requires the employment of specialist staff, please state how this work is critical to the delivery of your programme and contributes significantly to the criteria and set outcomes

Programmes must ensure that they have adequate staff supervision of the young people. If additional staff are required outside the normal ratio of 1:15 please provide an explanation

Please outline how your project represents value for money

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Youth Intervention Programme – Application Form 2018/19

I/We certify that the above information is correct. I/We agree to submit a report and financial statement, including relevant receipts at the end of the programme. If this is a joint initiative a representative from each group to sign below.

Signed: Signed:Name: Name:Position: Position:Date: Date:EnclosuresThe following documentary evidence must be submitted:Failure to produce required supporting documentation may lead to the application being rejected.Documents required Checklist

A copy of your governing instrument, constitution, rules or articles of association (signed and dated as adopted)

Copy of your Child Protection Policy

Insurance details including Public Liability and Employers Liability Insurance

Copy of Bank Statements for last three months

Please return this form to Education Authority, address provided below by 2 pm on Friday 20 April 2018

Jean MorninEducation AuthorityYouth Department

Grahamsbridge RoadDundonald

BelfastBT16 2HS

Email Address: sgp@eani.org.uk

The information provided on this form may be made available to other departments/ agencies for the purpose of preventing or detecting crime.

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