Lewisham sports small grants scheme
Applicationform

(Grow Stream)

Please complete this form with as much detail as possible to allow us to accurately assess your application for funding. Incomplete forms will not be taken forwards to the Assessment Panel.

Contactinformation (please print your details below)

Your name

Organisation/club name

Sport

Your position in organisation/club

Contact phone number

Contact email address

Contact address (including postcode)

Proposed costs

Total project cost (A)

Partner funding secured (B)

Total funding requested (A-B)

(Up to £4,000)

Breakdown of project/funding spend (please itemise proposed spend)

What / When / Cost
i.e facility hire for new U15 girls section / Apr ’13–Jul ’12 = 12wks x2hrs = 24hrs@ £25/hr / £600
Total costs

What are the aims of the project and how will the project/funding meet the necessary funding criteria? (Maximum 500 words)

Please refer to the grow stream criteria and evaluation information – the more detail you provide the more likely that your application will be successful

Is your club/organisation affiliated to a National Governing Body of Sport?

YesWhat is your affiliation number?

No

Is your club/organisation either Clubmark or Chartered Standard accredited?

Yes

No

Do you have Public Liability Insurance?

Yes

No

Please include all necessary evidence as described within the evaluation criteria on the Grow Stream fact sheet.(i.e. Copy of Constitution, Copy of NGB Affiliation etc)

Declaration

I declare that all information that I have provided in this application is true and that if successful I will abide by the awarding criteria/funding conditions as described by the funding body.

Name Date

______

Checklist

I have completed the application form fully

I have included all relevant information about my project and as to how it meets the funding criteria

I have included all necessary supporting evidence

I have kept a copy of my completed application for reference

Please return your completed application form (or if you have any queries) to Darnell Bailey:

Lewisham Sports Small Grant Scheme Application

Cultural and Community Development Service

2nd Floor Laurence House

Catford

SE6 4RU

Please note it is your responsibility to confirm that your application has been received and that incomplete application forms won't be taken forward to the judging panel.