Application for Funding–Organisations

Essential Criteria:

  • The organisations must be based in in Merseyside, North Wales, Cheshire (west of M6) or North Shropshire.
  • The equipment is supplied for the sole use of the organisation and their beneficiaries.
  • You have valid Public Liability Insurance.

Who is this grant for?
Organisation: / Charity Number/ Company Number:
Main address including post code:
Contact name: / Role in organisation:
Contact telephone number(s):
Email address:
A short paragraph about your organisation. It’s aims and regular activities.
Number of beneficiaries: / Their ages:
Disabilities:
Equipment
What equipment are you applying for?
Explain in your own words the benefits this equipment would bring.
Have you checked that it is suitable for the beneficiaries needs? Yes No
Have you checked that it will work/fit in the vehicle/premises? Yes No
Cost of equipment: £ Please attach a copy of the quotation from the supplier.
Can you pay anything towards the cost? Yes No If Yes, how much? £
Amount requested from The Steve Morgan Foundation £
Premises
We need to ensure that if this funding is agreed that you can install/use this equipment.
Do you own the premises? Yes No
Are the premises leased/rented? Yes No
If the premises are leased/rented, you may need permission from the leaseholder/landlord to install / use this equipment, please confirm that you have the necessary agreements in place? Yes

Conditions of Grant

The equipment requested and supplied must for the sole use of the beneficiary named in this application.

It is your responsibility to ensure that the equipment requested is fit for purpose and suitable.

It is your responsibility to ensure that all necessary insurance is in place with regards to the use of this equipment.

The Steve Morgan Foundation accepts no liability for the costs or arrangement of: maintenance, care, adaptation, operation or public liability of the equipmentonce it has been ordered.

Declaration
By signing this form, I confirm I have read, understood and agree to the terms and condition of the grant as stated above.
Signature: Date:
Have you:
  • Checked essential criteria to make sure you are eligible?
/
  • Attached quotes for the equipment?
/

Please return this form with all the required evidence

By email to:

By post to:Enable, Steve Morgan Foundation, PO Box 3517, Chester, CH1 9ET

Photographs
If your application is successful, we may want to take some photographs of the new equipment in use.
Would you be happy to gain the relevant permissions for your case study/images to be used? Yes

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29/08/17