Community Fund application form

Community Fund application form

for non-profit organisations in our supply area
SES Water is a local company supplying areas of east Surrey, parts of West Sussex, west Kent and south London and are proud to have served these communities for over 150 years.

Water is the most precious resource, yet we tend to take it for granted. To avoid future water shortages, we need a major culture shift in how we value water. That’s why SES Water is offering free home audits, free water-saving devices and fixing customers’ leaky pipes and toilets. There will be plenty of advice available and activities to get involved in, including supporting local non-profit organisations through a community fund donation scheme.

By completing this form, you are requesting a sum of money from the SES Water community fund for the benefit of a non-profit organisation / a project with a close link to water efficiency. SES Water may not be able to meet every donation request, but will carefully review each one. You must also be based within our supply area (see map below).
I confirm I am an SES Water customer*

Yes
Date of application*

MonthDayYear
Name of non-profit organisation*
Are you a registered charity?*

YesNo
Charity registration number *
Funds requested*

£200£500£1000
Details of the project and how the funds will be used *
Name*

First NameLast Name
Phone Number

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityCounty

Postal Code
Media consent statement

If you are awarded a sum of money through this application process, SES Water may promote your story (including any photography, film and words) through different platforms: in newspaper articles, magazines and other media such as websites social media, information leaflets, electronic newsletters, presentations and to publicise events.

You should only agree to SES Water using your photograph, film and words if you feel completely happy with this. You are under no pressure or obligation to sign this consent form.

You can contact SES Water at any point and ask not to use your photograph, film or words for any new purposes. Remember that once an article is published and in circulation (especially online) it may be copied and used by others. If you ask for the use your photograph, film and words not to be used in future SES Water will comply with your request and will do their best to stop others doing so, but this cannot be guaranteed.
I agree to the above media consent statement*
Should be Empty: