Preliminary grant application

Name*

E-mail:*

Telephone number:*

Area Code

Phone Number

web address (URL) if applicable

Organisation Name (Please use the exact name used on your bank account).

Bank details for BACS. payments

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 further information

For individuals please supply a letter(s) of support from an approved person/organisation e.g. Local Authority, charity, doctor, social worker and a quotation for the equipment, activity or service you are applying for. 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