Please Print Clearly and Ensure You Answer ALL the Questions on This Form s1

Please print clearly and ensure you answer ALL the questions on this form:

PART ONE –WHO IS THE GRANT FOR

1. Name of child/Organisation ………………………………………………..…………………………………………

2. Address………………………………………………………………………………………………………………………………….………………

………………………………………………………………………………………………………………………………………..……………………

3. Age of applicant or age range of children to benefit: …………………………………….…………………………………………..

4. How many children will benefit from this grant?…………………………………………………………………………………………

5. Telephone number of organisation or parent/guardian………………………………………..……………………………………

PART TWO – ABOUT YOU

6. Name of person making the application ……………………………………………………………………………………………………

7. Position in organisation, or relationship to child…………………..…………………………….……………………………………….

8. Contact phone number (daytime)…………….…………………………………….………………………………………………………..

9. Mobile Number………….. ………………………………………………………….………………………………………………………………

10. E-mail address………………………………………………………………………………………………………………………………………..

11. Address for correspondence…………………………………………………………………………………………………………………….

………………..……………………………………………………………………………………………………………………………………………

· If you are representing an organisation please go to question 12.

· If you are representing an individual child please go directly to question 13.

PART THREE – WHAT IS THE GRANT FOR

12. Background

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

ORGANISATIONS MUST SUPPLY THEIR MOST RECENT AUDITED ACCOUNTS

b) What geographical area does it cover?

……………………………………………………………………………………………………………………………………………………………...

13. What will be the estimated total cost of your project? £………………………….………………………………………………….

14. Please provide a detailed list of items the money will be spent on (try to identify a particular cost of an item rather than general expenses). Please enclose at least 2 written quotes.

15. Please note that any applications for computer equipment including software must be supported by information from an Occupational Therapist, Disability Team member, School Teacher or other recognised professional.

……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

16. Please describe how these item(s) would improve the day-to-day quality of life of the child(ren) concerned.

17. How much money have you already raised towards the total cost? £…………………………….

18. How much money do you wish to apply for? £……………………………………………………………

19. Have you ever applied to Radio Borders Cash for Kids for a grant?

20.

YES/NO. If YES, when was this, what was it for? Please state if you were successful or not.

…………………………………………………………………………………………………………………………….……………………………………………………………………………………………………………………………….……………………………………………………………

21. Have you tried to get funding from any other organisation?

…………………………………………………………………………………………………………………………….……………………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………….……………………………………………………………………………………………

PART FOUR – OTHER INFORMATION

22. Is there any other information you would like to be considered in support of your application?

IF YOU ARE REPRESENTING AN INDIVIDUAL CHILD YOU MUST ENCLOSE A SUPPORTING LETTER FROM A PROFESSIONAL WHO KNOWS THE CHILD E.G. HEALTH VISITOR, OCCUPATIONAL THERAPIST, TEACHER. THIS MUST BE SIGNED AND WRITTEN ON LETTER-HEADED PAPER

ADDITIONALLY WE WILL ALSO REQUIRE PROOF OF EARNINGS/OUTGOINGS.

PART FIVE – WHICH CHARITY IS SUPPORTING YOUR APPLICATION

Some applications for individual children are supported by a registered charity who will agree to accept payment on the individual’s behalf.

23. If a charity is accepting the payment on your behalf, please name the charity below.

…………………………………………………………………………………………………………………………………………………………….

24. What is their charity registration number?…………………………………………………………………………………………………

25. What is their address? ......

......

26. Name of contact person at this charity: ……………………………………………………………………………

27. Telephone number of contact person at this charity: ……………….………………………………………..

28. If your application is successful payment will be made by BACS, please complete bank details below::

Bank ……………………………………………………………………………………………………………………………………………

Account name ……………………………………………………………………………………………………………………………..

Bank Account Number ………………………………………………………………………………………………………………….

Sort Code …………………………………………………………………………………………………………………………………….

29. Are you happy for your details to be used in publicity material? For example on the radio, on our website, in newsletters etc? – please tick the appropriate box below:-

30.
Yes

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

When you have completed all the questions please sign the following declaration:

I am an authorised representative of …………………………………………………………………………………

(Name of organisation or child)

To the best of my knowledge, all information I have provided on this application form is correct.

Any grant we receive from Radio Borders Cash for Kids will be used exclusively for the purposes specified by the trustees.

NAME …………………………………………………………………………………………………………………………….

SIGNATURE ……………………………………………………………………….. DATE……………………………

When you have completed the application please return to:

Candy Rafferty

Radio Borders Cash for Kids

Radio Borders

Tweedside Park

Galashiels TD1 3TD

Tel: 01896 759 444

1. Radio Borders Cash for Kids exists for the sole purpose of helping children up to and including the age of 18.

2. Grant applications can only be made to children that live in/registered charities that help children in the Radio Borders broadcast area. (Map attached)

3. Consideration for grants will only be given to projects aiming to help children up to the age of 18 years who are sick, disabled or disadvantaged.

4. The Trust reserves the right to consider all grant applications individually and on their own merit and from time to time add to our main grant making criteria.

5. Favourable consideration will be given to those projects which directly benefit a number/large number of children and/or positively increase the quality of their lives.

6. Successful schemes will be of good quality with careful consideration being given to the safety and well being of children.

7. Grant applications must be accompanied by the most recently audited annual accounts of the organisation seeking the grant.

8. Timing of Applications:

Applications are submitted on an ongoing basis. The Trust meets several times a year and will reply to successful and unsuccessful applications shortly thereafter. Applications should be received one month before each trustee meeting (dates of the meetings can be confirmed by calling the charity administrator on 01896 759 444.

Grants can only be awarded to children who live within the official broadcast area of Radio Borders (the shaded section on the map below).

Bauer Radio’s Cash for Kids Charities (Scotland)

Registered Office: Forth House, Forth Street, Edinburgh EH1 3LE

Charity Number: SCO41421 – Company Number SC376887