Individual Applications – Online Form Please click here to read the notes on the application process before completing the online application form. 12 SECTION A This section must be completed for all applications. Name(Required) Prefix MissMr.Mrs.Ms. First Last Mobile PhoneHome PhoneWork PhoneEmail(Required) Date of Birth (if under 25) DD slash MM slash YYYY Address(Required) Street Address City County Post Code SECTION B1. EDUCATION DETAILS1.1 What are your educational qualifications to date?1.2 Where are you being educated currently?1.3 What is your current academic course?2 YOUR FUTURE PLANS2.1 Describe in detail the activity which you wish to undertake with the assistance of the Trust2.2 State the total cost of the activity £2.3 State how much grant you would like the Trust to make £2.4 State precisely how your own education will benefit from or be advanced by the activity which you wish to undertake3 FINANCIAL3.1 What other financial support do you have?3.2 What other applications have you made?3.3 When will you know the outcome of any other applications that you have made?3.4 Trustees prefer to make payment by BACS, so please provide:Name of BankName of AccountSort CodeAccount No4 GENERALLYAttach any supporting documents here.Max. file size: 512 MB. Have you attached any information to this application? Yes No Consent(Required)Please read the declaration and agreement below carefully and then sign where indicated. 1 I declare that the information given in sections A & B is true to the best of my knowledge information and belief. 2 I agree to tell you if other financial support is given or promised in respect of the project between the date of the application and the Trustees' meeting. 3 I agree to reimburse the Trust for any money received from the Trust in the event of the money raised for the project exceeding the anticipated costs thereof as hereafter stated. 4 I agree to your enquiring of other Trusts in Lichfield as to whether or not they have or are likely to make a grant in my favour. I agreeDate DD slash MM slash YYYY