Junior Chamber International United Kingdom

APPLICATION FOR A JCI UK FOUNDATION GRANT

NAME OF APPLICANT

(CHAMBER/REGION/JCI UK/INDIVIDUAL *)

CONTACT

NAME

ADDRESS

E-MAIL ADDRESS

TELEPHONE NUMBERS

AMOUNT OF GRANT REQUESTED

(If there is insufficient space to complete your answers to the questions below, please feel free to continue in the ‘Any other relevant information’ section on the next page or on a separate sheet)

Please provide a brief summary of the overall project/activity for which the Grant is required indicating specifically how the project is anticipated to assist recruitment / retention / JCI UK goals

.

Please indicate which part of the activity/event will be supported by the Grant

How will this activity benefit one or more of the following and how will the benefit be measured:

1) the Chamber; 2) the community; 3) individual members.

.

Please attach a budget for the activity AND indicate the source of other funds (if any) being used in the activity (e.g. sponsorship, sale of tickets, Chamber reserves) and the total likely expenditure.

Please attach a copy of the latest set of audited or certified accounts for the Chamber.

Any other relevant information.

.

DECLARATION

I confirm that any Grant awarded to JCI [ ]*, as a result of this Application will be used only for the purpose outlined in this Application. * = please complete as appropriate

Signature of Chamber President/Regional Group Chairman/other appropriate individual

Name of person signing above:

Position held:

Date

When completed, this form should be sent to Elaine Senior, Clerk to the Trustees, 1 Roman Court, Rotherham, South Yorkshire, S61 2HN. Home Tel (01709) 552338 or Mobile (07914) 182347 or by email to:

The Trustees will seek to deal with all applications promptly, usually within 2 weeks. Please ensure this application is submitted within 8 weeks of the event/activity

IMPORTANT INFORMATION

Preference will be given to events whose main aim is membership recruitment and retention.

All applications will be acknowledged by e-mail within seven working days of receipt. It is the responsibility of the applicant(s) to contact the Clerk to the Trustees if an acknowledgement is not received within this time.

Attribution to and use of the JCI UK Foundation name and branding is a condition of grant aid to promote awareness of the Foundation.

All applicants must submit a brief report to the Clerk to the Trustees within one month of the event taking place. The report should contain copies of promotional material for the event and demonstrate clearly how the Foundation name was used, detail the benefits achieved by the event and the impact of the Foundation funding.

In some cases, the Trustees may require clarification/confirmation of certain aspects of your application. When this happens, the Trustees commit to seeking this information immediately after the meeting at which your application is considered. If further information/clarification/confirmation is not received within 6 months, the application will be deemed to have lapsed.

JCI UK Foundation Grant FormPage 1 of 2

Issue 3 – January 2006