Community grant funding form

Community Grant Funding Application 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*

Project Completion Date*

Total Cost of Project*

Funding Requested*

Contact Name*

Position held in Organisation*

Registered Charity*

Yes

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

Max. file size: 5 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

Max. file size: 5 MB.

Evidence or any permissions or consents relating to this application

Drop files here or

Max. file size: 5 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:*

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

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*

Full Name

Position in Organisation

Date

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

CAPTCHA

Community grant funding form

Community Grant Funding Application Form

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

Please Upload the following as applicable:

PART 2 - BUDGET DETAILS

Please provide a breakdown of the costs of the project

Grant Rquested

YOUR ACCOUNTS

Income

Reserves

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:

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

PART 3 - YOUR PROJECT

Project Information

Tell us about your project and your reasons for appying to Farnham Town council for grant Funding

OTHER PARTNERS OF YOUR PROJECT

Partner/s

Role

PROJECT IMPLEMENTATION

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

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.