Organisation Name:
Email:
Postcode:
Website address:
Contact name:
Position in organisation:
Organisation Address:
Telephone No:
Which area or community does the organisation serve? :
What is the status of the organisation? Charity, CIC, other? Charity Registration number if applicable.
Are you a registered for VAT? yes no
Do you have a bank account in the name of your organisation? : yes no
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
I declare that the Statements made are, to the best of my knowledge and belief, correct in every respect.
Signature of Applicant:
Date :
Income and Expenditure: (Please complete if accounts not available)
INCOME
Total
EXPENDITURE
TOTAL EXPENDITURE
CAPITAL AND PROPERTY
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 funding? If so, please list all organisations you have applied to, 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
Please continue these sections on an extra sheet if necessary:
What is the funding application for? Please give specific details about how the budget will be spent and what the project or funding aims are.
I declare that the Statements made are, to the best of my knowledge and belief, correct in every respect.
Signature of Applicant:
Date :
Can you demonstrate the need for the funding and local stakeholder support through consultation or other means?
Who will be responsible for the expenditure of the grant and/or delivery of the project?
I declare that the Statements made are, to the best of my knowledge and belief, correct in every respect.
Signature of Applicant:
Date4 :
How will the outcomes of the grant expenditure support Chester Municipal Charity’s aims and what positive, sustainable change will result from the grant?
Have you been offered match funding from other organisations?
Any other comments.
I declare that the Statements made are, to the best of my knowledge and belief, correct in every respect.
Signature of Applicant:
Date :
