Support Group Grant Application

Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Email

Phone Number

Area Code Phone Number

Support Group Name

Support Group Position

Support Group Area

Support Group Website

Support Group Facebook Page

Is your group listed at http://ukfibromyalgia.com/pages/support/support_map.php ?

Does your group website link to UKFM?If not, please add a link using http://ukfibromyalgia.com/linkback.php

Does your group subscribe to the Fibromyalgia Magazine?

How many meetings do you average per year?

How many regulars do you have attending your meetings?

Do you produce your own in-house newsletter?

Could you take some photographs of your group and write some copy about your plans for the group and the event(s) if the grant was successful? (I like to feature an article on the groups helped in magazine.)

Could you include an advertisement for magazine subscriptions in your in house publicity and your website if the grant goes ahead?

Background information about what the money is needed for:

Funding required (maximum £100.00)

Have you applied for a grant from us before?

Date you require the money

Day Month Year Date Picker Icon

Cheque payable to (if your application is successful, you should be aware that I can only pay out grants to named support groups, not to private individuals' accounts)

Additional comments

Please enter the characters as shown *