Your Details

Title

First Name

Last name

Your role in the organisation

Contact Address

Postcode

Telephone number

Mobile number

Email address

Organisation details

Organisation name

Organisation address

*Postcode

Organisation telephone

Organisation website

*Please note we can only work on low carbon energy related projects located in the Dorset Council area – you can check if your premises are in the area on this UK Government Local Council finder page

Community group profile, activities, and structures

Brief overview of your community organisation and what it does

Please select what type of legal structure your business has (tick which apply):
Unincorporated associationCharitable TrustCharitable Incorporated OrganisationCommunity Benefit Society/Cooperative SocietyCommunity Interest CompanyLimited Liability PartnershipDevelopment Trust/Social FirmOther (please list)

Date of incorporation or registration (if applicable)

Registration number

Is your organisation VAT registered? (if yes, please provide VAT number)
YESNO

Energy use

Please note: If you have more than one location in the Dorset Council area that you would like us to assess, it would be helpful to split out the energy use and costs at each site – thank you.

What is your current annual electricity spend and what is it used for?

What is your current annual spend on gas and what is it used for?

What is your current annual spend on oil and/or LPG and what is it used for?

About the support you might need

Please tell us any specific areas you think you are interested in (tick all that apply)
Energy efficiency/savingRenewable energy generationSupport with all viable low carbon energy optionsOther (please list)

Please outline any specific project ideas you already have and explain how far you have developed these.

If there is anything else you think would be useful to tell us, please use this space.

Subsidy Control

Low Carbon Dorset is provided through the UK Government’s Shared Prosperity Fund (SPF) and must comply with rules on Subsidy Control. It is your responsibility to understand the Subsidy Control implication of your application for your organisation. Please confirm below if you have received grants or other support subject to Subsidy Control in this financial year or the previous two financial years (you might also know this as State Aid). Please note that only one SPF grant is allowed per organisation. If we need more details following your expression of interest, we will let you know. Note that the following (among others) can be classed as subsidies/aid: Grants, loans, tax breaks, including enhanced capital allowances, and the use or sale of a state asset for free or at less than market price.

If the free technical advice you receive from Low Carbon Dorset qualifies as Subsidy Control we estimate that your organisation will receive 15 hours of technical support from Low Carbon Dorset. This support will be free to you but has a value for Subsidy Control purposes of £870, delivered via the Minimum Financial Assistance route, which currently has a maximum threshold of £315,000 in any three-year period.

Has your organisation received any State Aid/Subsidy Control in the last three years?
YesNo

If you answered YES, please provide further details including:
- The Public Authority giving the aid e.g. Levelling Up Funds
- The £ Value of the aid e.g. £75,000
- Date aid received e.g. 08.12.2022
- Route used to give the aid e.g. Minimal Financial Assistance (similar to de minimis for EU state aid)

Date submitted to Low Carbon Dorset

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