SMALL FUNDING REQUEST

APPLICATION FORM FOR THE GRANT GIVING FUND

SMALL FUNDING REQUEST (UNDER £500)

Organisation Name:

Email:

Postcode:

Website address:

Contact name:

Position in organisation:

Organisation Address:

Telephone No:

Which area or community does the organisation serve? :

Are you a registered for VAT?
yesno

Do you have a bank account in the name of your organisation? :
yesno

Please provide a copy of:

the Charity Deed, Scheme or other governing document for the organisation
information of the trustees or management board members if not included in above
the annual report if available
the last two years accounts if available, including a bank statement signed by a trustee or similar

I declare that the Statements made are, to the best of my knowledge and belief, correct in every respect.

Signature of Applicant:

Date :

Have you applied to any other organisations for this project? If so, please list all organisations you have applied to for this project, including ones that have not yet decided or have rejected the application.

Name of Organisation

Date Applied:

Specify Outcome: Grant/ Rejection/ Awaiting decision

If successful: Date grant received

If successful: Amount of Grant

Please continue these sections on an extra sheet if necessary:

What is the funding application for?

How will the outcomes of the grant expenditure support Chester Municipal Charity’s aims?

I declare that the Statements made are, to the best of my knowledge and belief, correct in every respect.

Signature of Applicant:

Date :

The completed application and copy supporting documents should be forwarded to:
Dee Denton, Administration Officer, The Bluecoat, Upper Northgate Street, Chester, CH1 4EE
email: office@thechesterbluecoatcharity.co.uk

For further information please telephone 01244 345787

Any information submitted will be held securely and in accordance with the Charity’s data protection policy.

APPLICATION FORM FOR THE GRANT GIVING FUND