THE ERNEST HECHT CHARITABLE FOUNDATION

Registered Charity No: 1095850

APPLICATION FORM

Please return your completed form to:

Applications will be only be considered from UK based registered charities.

You are asked to read the general guidelines on the Foundation website before completing and submitting this application form.

SECTION 1 - APPLICANT DETAILS

Name of Organisation:
Contact Address:
Contact Name:
Daytime Landline: / Direct Line:
Mobile Number:
Contact E-mail:
Charity Number:
Date Established:
Website Address:
Geographical Area of Benefit:
Funding Amount:
Please complete all sections of the application form before ticking the following boxes:
All sections completed: / Accounts attached: 1st set 2nd set / Last page signed:

SECTION 2 – DETAILS OF PROJECT / GRANT REQUEST

Please give details of your request by answering the following questions in as much detail as possible.
2.1 - Information about your charity
2.2 - Purpose of your application (no more than 800 words)
2.3 - Geographical area of benefit covered by your charity
2.4 - How the proposal meets the Foundation’s aims
2.5- Amount requested
2.6 - Breakdown of how the funds will be used
2.7 -Details of the projected participants / audience / venue (if applicable)
2.8 -The expected benefit to society from this proposal / project
2.9 -Intended advertising and promotion and confirmation that you would be willing to acknowledge the Ernest Hecht Charitable Foundation for any grant they may provide in such promotional material
Please notethat allof the above questions mustbe answered for your application tobe considered.

SECTION 3 –FINANCE

Please provide the following details from your most recent annual accounts:

Account year ending: (day/month/year)
Total income (gross) / £
Total expenditure / £
Balance at end of account year / £
Savings (reserves, cash, investments) / £

In addition to the above information, please provide electronic or scanned copies of your most recent two years audited accounts alongside this application

SECTION 4 – PREVIOUS APPLICATIONS

Have you previously applied to the Ernest Hecht Charitable Foundation? Y / N
If Yes, please complete the following section. If No, skip to Section 5
If so, was your application successful? Y / N
What was the date(s) of your application(s)? / How much did you receive?
For what purpose was the grant(s) awarded?
What have the principal benefits of our previous funding been for your organisation?

Section 5 – Declaration

PLEASE PRINT THIS PAGE

After printing, please sign below using black ink, scan this page and attach it to your application email.

I believe, to the best of my knowledge, that the information given in this application is true and accurate.

Signature: / Position Held:
Print Name: / Date:

Please tick checklist on first page before sending your completed application, ensuring that this page and two sets of accounts are attached.

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