Preliminary grant application

Name*

E-mail:*

Telephone number:*

Area Code

Phone Number

web address (URL) if applicable

Organisation Name

Please choose one of the types of organisations you represent*

Type of organisation if not list above

If a charity, company or other registered body or organisation please give your Registration number. If not registered please enter 'not applicable'*

If an individual are you a UK tax resident*

Yes

Not applicable

Address line 1*

Address line 2*

Post code*

Please describe the aims of your organisation and the services you provide *

Are all the individuals/groups disabled wheel chair users

Yes

If not please let us know the numbers who are

Have you applied before? If yes please give us details*

Please indicate clearly in less than 100 words for what the funding is intended*

Please provide a budget for the project that is the subject of this application*

Please use this area to provide any further information

For individuals please supply a letter(s) of support from an approved person/organisation e.g. Local Authority, charity, doctor, social worker. Use the button below to upload documents, maximum size is 2MB, PDFs are recommended

For an organisation application, please supply a copy of your latest income and expenditure and balance sheet. Use the button below to upload documents