Organisation Applications – Online Form – Lichfield Conduit Lands Trust

Before completing the online application form – please click here to read the Application notes. If you have any questions please email srjames@lichfieldconduitlands.org.uk.

SECTION A
This section must be completed for all Applications whether for an individual, group or organisation. The information to be given is either for the individual making the application or for the individual making the application on behalf of an organisation or group.

Full name of person completing this application form:(Required)

Prefix First Last

Mobile Phone

Home Phone

Work Phone

Email(Required)

Date of Birth (if under 25)

Address(Required)

Street Address City County Post Code

SECTION B

1.ABOUT YOUR GROUP OR ORGANISATION:

1.1 Name of your group or organisation with (if applicable) your Registered Charity Number

1.2 If you are part of a national group or organisation, name of that group or organisation and (if applicable) its Registered Charity Number

1.3 Please provide a copy of your accounts for the last year.

Max. file size: 512 MB.

1.4 What is your charitable purpose?

2 ABOUT YOUR PROJECT

2.1 Describe in detail the project that you wish to undertake with the assistance of the Trust

2.2 How much will the project cost?

2.3 How much grant would you like the Trust to make to you?

3 FINANCIAL

3.1 What other financial support do you or your organisation have?

3.2 What other applications have you or your organisation made for support?

3.3 When will you or your organisation have the outcome of any other applications you or they have made?

3.4 What financial reserves do you have?

3.5 How much have you raised already?

3.4 Trustees prefer to make payment by BACS, so please provide the following details: If you do not want to make payment by BACS please let us know to whom the cheque should be made payable:

Name of Bank

Name of Account

Sort Code

Account No

4 GENERALLY

Have you attached any information to this application?

Yes

Date