Charity Registration No: SC 041421 / MFR Cash for Kids
Application for Funds
CONFIDENTIAL / G

PLEASE PRINT IN BLACK INK OR TYPE ONLY & PLEASE NOTE THAT THE FORM MUST BE SIGNED

PART 1 – WHO IS THE GRANT FOR?

Name of Organisation:
Contact Name: / Position Held:
Address:
Postcode: / Telephone:
Charity Number: / Which are you? / Private or LocalAuthority(delete as appropriate)
Age range of children
to benefit: / How many children will benefit from this grant?:

PART 2 – WHAT IS THE GRANT FOR?

What are the aims & objectives of your project and who will it benefit? (please give a summary)

For what purpose is the funding required? Please identify a particular cost of an item rather than general expenses.

If applying for larger items please include quotes.

What other steps are you taking to raise funds and what other organisations have you applied to?

Please include the status of these applications and if unsuccessful please explain why you were turned down for funding.

The Local Executive Board also require a copy of your latest financial accounts.

Please include this with your application.

Amount requested / £ / Have you previously applied?
Amount already raised / £ / Were you successful?

Should your application be successful please supply us with the following:

Bank / Account Name
Sort Code / Account Number

Are you happy for your details to be used in publicity material? For example on the radio, on our website etc.

Yes / No / Yes, but please change the names used in any material

Part 3 – ENDORSEMENTS We ask for two endorsements. Both must be willing to talk about your application and MUST sign the form or your application will be invalid. Scanned copies will be accepted.

1)Chairperson or Committee Member (someone who leads or manages your organisation but not the person given Q1)

Full Name :
Position in Organisation:
Address:
Postcode: / Telephone:
To be best of my knowledge the information given on this form gives a true and accurate account of this organisations work and needs.
Signed: / Date:

2)Independent (someone who is independent of your organisation but knows your work well)

Full Name :
Organisation: / Position Held:
Address:
Postcode: / Telephone:
I know this organisation well and can talk to you, if necessary, about its work.
Signed: / Date:

PART 4 – DECLARATION

When you have completed all the questions the following declarationMUST be signed:

I am an authorised representative of ______(organisation) to the best of my knowledge, all information I have provided on this application form is correct. Any grant we receive from MFR Cash for Kids will be used exclusively for the purposes specified by the trustees.

Name :
Signature: / Date:

Check List (please ensure you have done the following before returning the form)

Have you completed every question on the form?
Have you enclosed your latest financial accounts?
Have you given full details for two endorsements?
Have you signed the form?
Have you kept a copy of this application for your own record?

Please return completed forms to:MFR Cash for Kids, PO Box 271, Invernessor

PLEASE NOTE: This application will not be acknowledged.