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Community Grant Funding Form
Community Grant Funding Form
"
*
" indicates required fields
If you wish to complete this form in stages then please click the ‘SAVE AND CONTINUE LATER’ button found at the end of the form. PLEASE NOTE YOU CAN ONLY SAVE ONCE. THE FORM MUST THEN BE COMPLETED AND SUBMITTED
PART 1 – ORGANISATION DETAILS
Name of Organisation
*
Project Name
*
Project Location
*
Project Start Date
*
DD slash MM slash YYYY
Project Completion Date
*
DD slash MM slash YYYY
Total Cost of Project
*
Funding Requested
*
Contact Name
*
Position held in Organisation
*
Registered Charity
*
Yes
No
Registration No.
*
If NO, state type of organisation
*
Organisation Address
*
Postcode
*
Email
*
Telephone
*
Bank Account Name
*
Bank Address
*
Sort Code
*
Please enter a number less than or equal to
999999
.
Account Number
*
Please enter a number less than or equal to
99999999
.
Please Upload the following as applicable:
Location plan or site plan
Drop files here or
Select files
Max. file size: 4 MB.
Copy of constitution or set of rules if not submitted or changed since you last applied for a grant from Farnham Town Council
Drop files here or
Select files
Max. file size: 4 MB.
Evidence or any permissions or consents relating to this application
Drop files here or
Select files
Max. file size: 4 MB.
PART 2 – BUDGET DETAILS
Please provide a breakdown of the costs of the project
Item
*
Cost £
*
VAT £
*
TOTAL £
Item 2
Cost for item 2
vat for item 2
Total for item 2
Item 3
Cost for item 3
vat for item 3
total for item 3
Item 4
Cost for item 4
vat for item 4
total for item 4
Item 5
Cost for item 5
vat for item 5
total for item 5
TOTAL PROJECT COSTS
Total Cost
Total vat
Project Total
Grant Rquested
Grant Requested
*
% of total cost
*
YOUR ACCOUNTS
Please provide a breakdown of your latest set of accounts as at:
*
DD slash MM slash YYYY
Income
Income from Grants, Donations (excluding Farnham Town Council)
*
Income (Other)
*
TOTAL INCOME
*
Operational Costs
*
Net Surplus/Deficit
*
Reserves
Cash/Bank/Debtors
*
Creditors (monies owing)
*
Earmarked Reserves
*
Available Reserves
*
Earmarked services explanation
*
PREVIOUS FARNHAM TOWN COUNCIL FUNDING:
Have you applied to Farnham Town Council for grant funding before? If Yes, please provide information for the last 3 years:
Previous funding 1
Previous funding 2
Previous funding 3
Previous grant year 1
Previous grant year 2
Previous grant year 3
OTHER FUNDING SOURCES:
Please tell us about other funding that you might receive for this project.
Have you applied for funding in respect of this project to any other organisation? Please give details of source and amounts applied for.
Organisation
Amount Applied for
Outcome or state when outcome will be known
Surrey County Council
Surrey County Council amount applied for
outcome surrey county council
Waverley Borough Council
Waverley Amount Applied For
outcome waverley
Town or Parish Council
Waverley Amount Applied For Town
outcome town/parish
Which town or parish council
National Lottery
Waverley Amount Applied For Lottery
outcome lottery
Which town or parish council
Other (Provide Details)
Waverley Amount Applied For Other 1
outcome other
Waverley Amount Applied For Other 2
outcome other 2
Waverley Amount Applied For Other 3
outcome other 3
Waverley Amount Applied For Other 4
outcome other 4
Waverley Amount Applied For Other 5
outcome other 5
Waverley Amount Applied For Other 6
outcome other 6
Waverley Amount Applied For Other 7
outcome other 7
how operate in future
*
PART 3 – YOUR PROJECT
Project Information
Tell us about your project and your reasons for appying to Farnham Town council for grant Funding
Project Aims and Timescale
*
Project description
*
How does it benefit community
*
who will benefit and measure of effectiveness
*
Approx. how many local residents will benefit?
*
What percentage live in Farnham?
*
How many members in your organisation?
*
If your organisation assists other people, what percentage live in Farnham?
How do you know need for project
*
What Consultation has there been
*
OTHER PARTNERS OF YOUR PROJECT
Partner/s
Role
Partner 1
Role 1
Partner 2
Role 2
Partner 3
Role 3
Partner 4
Role 4
Partner 5
Role 5
Partner 6
Role 6
PROJECT IMPLEMENTATION
responsible for project
*
Who owns the land/property (if applicable)
Has permission been obtained from the land owner? (if applicable)
Yes
No
When will permission be obtained?
contracts leases
What other consents/permissions are required? State when these will be obtained.
If your organisation is successful with the initial application process you may be invited to make a presentation to the Farnham Town Council’s Strategy and Finance Working Group.
DECLARATION
This grant application should be signed by two members of your Organisation’s Committee, one of whom must be the Chairman, Honorary Secretary or Honorary Treasurer. We hereby certify that the information supplied in this application is correct and we confirm that any grant awarded by the Council will be spent only on the purpose for which it was given.
Full Name
*
Position in Organisation
*
Date
*
DD slash MM slash YYYY
Full Name
Position in Organisation
Date
MM slash DD slash YYYY
By ticking this box you agree that the information given is correct
*
I Agree
Please tick the box below to confirm that you agree to us collecting, using, storing and sharing your personal information in accordance with the Farnham Town Council Privacy Policy
*
I Agree
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Last Updated:11th November, 2021, 11:29 AM
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