Grant Application Form

Please fill in the application details below if you wish to apply for a grant or provision of free/subsidised space or mentoring in connection with the objects of the Charity as described on our website, together with our grant-making policy.

Our Charity Committee will discuss each application and inform you (within 10 days) whether your bid was successful.

Name/Organisation*

Name of Applicant

First NameLast Name

Email

example@example.com

Address*

Street Address

Street Address Line 2

CityCounty

Post Code

Website

Please list your aims, activities of your organisation (or why you are applying for this grant or support, if individual) - attach additional pages if necessary:*

Please detail what activity you are applying for to be funded or supported and when you expect it to take place:*

What is the outcome expected of this activity and related costs, how will the grant and activity help, how will this be measured and when will you know that it is complete?:*

Have you applied for funding or support elsewhere/how much have you already raised towards it?:*

Do you expect to carry out similar activities following this or sustain the activities in some way and how will you do this?:*

How will you carry out your activity/meet your aims if this bid is not successful?:*

How did you hear about us?:*

Please provide the name and contact details of a suitable referee who can verify that you are in need of this funding and also verify the answers given above (if you are an organisation that can provide any accounts in support of your application and details of your activities please do so, including budgets if this relates to a production or event):

Name of referee:*

First NameLast Name

Connection to you/the organisation:*

Referee email:

Referee phone:

Additional information. If the information provided relates to any of the above questions, please state which:

I can confirm that all of the information provided above is the truth and understand that any false information could hinder my application.*

I agree with the above statement