The MethodistChurch Nottingham and Derby District
Application for a Grant from the District Advance Fund-Form N (Issue 0911)
(Please refer to Notes for Guidance before completing. For workers consult District Lay Employment Secretary before completing)
Supplementary Forms P,Q & either R or S must accompany this form)
1. Circuit …………………(22/….) Church (if applicable)………………
Support is requested for Personnel Scheme (delete as appropriate)
Title of Scheme/project……………………………………………………………
2. Amount requested (see Note 3) Start date…………….
2013-14 / 2014-15 / 2015-16 / 2016-17 / (2017-18)* / (2018-19)* / Total£ / £ / £ / £ / £ / £ / £
* Stationing appointments only
3.(a) Circuit Details No. of Churches………….No of Manses…………….
(b) Circuit Advance Fund and commitments agreed by Circuit Meeting
(Obtain information from Circuit Treasurer and/or Superintendent Minister)
Column A / Col B-£k / Col C-Name of agreed commitment / D-Amount-£k1 / SUMMARY / Est. Levy (2.5% on 1st £100k, 5% on rest)
2 / Value of CMTF at 31 Aug last / This project
3 / Additions from sales
4
5
6 / Sub-total / .
7 / Total Committed (as Row 8Col D)
8 / Uncommitted balance (Rows 6 –7 ) /
Total (insert value in Row 7 Col B)
4. Aim of project/Scheme
5. Brief Description of project/scheme (not more than 200 words)
6. Objectives of project/scheme (not more than 200 Words)
7. For non-property schemes, how will it be monitored (100 words max)
8. Any special circumstances which make this application particularly worthy of a DAF Grant (100 words max)
9. Enclosures/ attachments (tick Boxes)
Mission statement(s) (Note D4) ; FormsP (church) orP (circuit) Q andfor buildings R orfor personnel /ecumenical work S
Certificate/ Letter from Prof. Advisor re costs associated with disability (if appropriate)
10. For Property Schemes. When scheme was/will be entered on the Consent web-site …………
For Personnel Schemes. Proposed start date…………..
11. Correspondent. Name……………………..
Address………………………………… …………. ………… …… …… ……………………………………………………………………………..Post Code………………………..
Tel No………………………E-mail……………………………………………………………………………
Official position………………
12 For Workers, this application was discussed with the District Lay Employment Officer
Signed…………………………………………(DDE) Date…………………………………
13The application wasapproved by the Church The application was approved by the Circuit
Council held on ………………Meeting held on……………..
Signed…………………………….(Secretary)Signed…………………………….(Secretary)
……………………………………(Chairman)…………………………………….Chairman)
One completed and signed set of forms and mission statement should be sent to Mr Peter Broekhuizen (District Grants Officer) 8 The Teasels, Bingham, Notts. NG13 8TY. If possible a second set should be e-mailed.to
The Committee will meet in October, January and May. Deadlines for receipt of applications are 15 September, 15 December and 15 April respectively.Applicantswill normally be notified of decisions around the middle of the month following the deadline.
For Official Use only. M/C Scheme No. ……………. Date received………… …DGC/P mtg…………………
Signed copies received
Award
2012-13 / 2013-14 / 2014-15 / 2015-16 / 2016-17 / 2017-2018 / Total£ / £ / £ / £ / £ / £
Notes