The Galloway Association of Glasgow

an independent Scottish Charitable Trust, No SC006642

Website: www.gallowayassoc.org.uk

Application for Funding by Organisations

This Form must be used by Organisations who are seeking financial support. Please use a suitable word processing package (such as MS Word 2010 or 2013) to enter the required information into each Field on the Form. Thereafter, the completed Form should be sent by e-mail to the Association (see 8. Guidance Notes below).

1.  Name and Address of Organisation Requesting Funding
Name of Organisation:
Address:
Post Code:
2.  Name and Address of Contact
Name of Contact:
Position: / Chairman Secretary Treasurer Director TrusteeOther (specify): / Select from drop down list.
Contact Address:
(if different from above)
Post Code:
Telephone Number:
3.  Charitable Status
Are you a Charity? / Charity Non Charity / Select from drop down list.
Charity Reg Number:
Constitution Enclosed? / Constitution Enclosed Constitution Not Enclosed / Select from drop down list. If not a Charity, please enclose a copy of your Constitution.
Total Annual Income:
Accounts Enclosed? / Accounts Enclosed Accounts Not Enclosed / Select from drop down list. Please verify Income with your last Audited Accounts.
4.  Name and Address of 1st independent Referee who can vouch for this Project
Name of Referee:
Address:
Post Code:
5.  Name and Address of 2nd independent Referee who can vouch for this Project
Name of Referee:
Address:
Post Code:
6.  Grant Application
Title of Project:
Web Site for Project or Organisation
Description of Project and expected outcomes for which funds are requested:
£ Estimated Cost of Project:
£ Amount Requested:
£ Funding already promised or received: / Note : include contributions from members of the organisation if appropriate.
Source of Funding already promised or received:
Any other Comments:
7.  Declaration
I confirm that:
·  All the information given in this application to be true and that I will inform you of any major changes to our financial circumstances during the consideration of the Application and the period of any award.
·  I will acknowledge receipt of the cheque from the Association within two weeks.
·  I will acknowledge the contribution that the Association has made to this project in relevant publicity material, such as websites, leaflets, posters, exhibition catalogues, guidebooks, adverts and press releases.
·  I will submit a written report to the Association describing the activities funded by the award, including at least one high-quality digital image relevant to the project.
·  This Application does not fall into any of the following categories:
o  Applications of a commercial nature.
o  Applications to meet salary or remuneration costs.
o  Applications to meet regular maintenance or day-to-day running costs.
o  Applications that are not directly connected with Wigtownshire or the Stewartry of Kirkcudbright.
o  From organisations that have significant unrestricted reserves.
o  From large national charities which enjoy widespread support.
o  From groups who then distribute the funds as grants or bursaries to others.
o  Applications that are the primary responsibility of statutory funders such as local and central government and health authorities.
o  Applications for subsequent years of undergraduate or postgraduate study.
o  Applications by groups or individuals to support day trips or overnight accommodation such as school outings.
o  Successful applicants will not be considered for a period of eighteen months following receipt of a grant.
·  The information on this Application may be recorded in computer systems operated by the Association for the purpose of processing this application and general administration.
Signed:
Dated:
8.  Guidance Notes
Additional copies of this form can be downloaded from our Website: www.gallowayassoc.org.uk
The completed Application Form should be sent as an attachment to an e-mail to together with any supporting documents, preferably in pdf or Office 2003 format. Each attachment must be less than 1MB (1000k) in size.
Returning the Form electronically by e-mail will help process the application more speedily. Alternatively, the completed form can be printed and posted to The Honorary Secretary, The Galloway Association of Glasgow, 46 Kingsheath Ave., Rutherglen, Glasgow G73 2DE
Any additional material about your organisation or the project, which you consider may be useful to the Association in considering your application, will be welcome.
Galloway Association of Glasgow / Funding Application Form for Organisations (web.2017.06.27) / Page 1 of 4