Skelton BountyApplication Form

Please complete all sections and please do not attach any additional sheets to this form. We may request additional information at assessment. Please note the word count.

section A: about your Organisation

Name of organisation:
Contact address:
Contact names and details:
Main Contact / Alt. Contact
Name:
Position:
Telephone:
Mobile:
Fax:
Email:
What are your organisation’s main or current activities?
Is your organisation:
A registered charity? / Charity Number:
Applying for charitable status?
A company limited by guarantee? / Company Number:
When was your organisation established? / Year: / Month:
Are you part of, or affiliated to, a larger organisation? / NO
(If yes, please give details, including head office address)

How many people are involved in your organisation?

Full time paid staff: / Part time paid staff:
Management Committee members: / Volunteers:
What was your organisation’s total income in the last three years?
20113/14: / Notes:
2014/15: / Notes:
2015/16: / Notes:

Bank account details:(This should be an account in the name of your organisation with at least two signatories.)

Name of Bank/Building Society:
Account Name:
Account Number:
Sort Code:
If you are successful in your application, to whom should the cheque be made payable?(NB This should be an organisation, not an individual. If you do not have a bank account for your organisation, please provide details of a community organisation that will accept the grant on your behalf.)
SECTION B: ABOUT YOUR APPLICATION
B1: Please tell us about your project and who will benefit (Max 250 Words)
When will the project take place? / Start Date: / End Date:
B2. Please give an estimated number of beneficiaries for this project:
Total estimated beneficiaries:
B3. Please tell us how the need for the project was identified (Max 250 words)
B4.How will you monitor the progress of the project and evaluate its success?
(Max 150 words)
SECTION C: FINANCIAL INFORMATION
C1. Have you received grant funding before from Skelton Bounty? If Yes, please give date:
C2. How much are you requesting?
C3. Are you seeking further funds from any other organisation?
If yes, please give details of the amount and when the outcome will be known:
Organisation / Amount applied for / Date of outcome
C4. Please give details of the costs for the project:
Revenue(please break down as appropriate e.g. hourly rates, hours per day/week etc)
£
£
£
£
£
£
Capital(money which will be spent on single items of equipment or asset that cost £500 or more and have a life of more than one year)
£
TOTAL
Please attach suppliers' or providers' cost estimates or quotations if available.

DECLARATION

Before signing the declaration, please ensure you have completed all the sections in this application form, and that you have enclosed the documents requested on the checklist below where applicable

1.Please enclose the following documents with this application (tick boxes on the checklist):

The constitution / set of rules of your organisation

Your organisation’s latest annual accounts or income/expenditure statement for the last 12 months

A copy of your organisation’s most recent bank

statement OR letter of confirmation from a community

group that will accept funds on your behalf

A copy of your organisation’s Child Protection/Safeguarding

Policy Vulnerable Adults Protection Policy if your organisation

works with vulnerable adults

2. I am an authorised representative of the organisation. To my best knowledge, the information provided in this application form is correct.

Print name

Position in

organisation

Date

Please return this form via email in word format,to supporting documents may be posted to

Skelton Bounty Grants Programme,

LCVS, 151 Dale Street, Liverpool L2 2AH 0151 227 5177

The closing date for applications is 5pm on 31st May 2017.

The Skelton Bounty

Registered charity number 219370

The Skelton Bounty is a charitable trust empowered to make grants only to legally constituted charities established in the geographical County of Lancashire (as it existed in 1934).

Although the Governors enjoy complete discretion when considering applications, they are inclined to favour applications for:

  • Equipment from organisations supporting the elderly, people with disability and from youth groups
  • Small specific capital projects of proven viability from community groups

The Governors do not usually fund:

  • Large building appeals
  • Revenue expenditure

and do not make grants to individuals.

It is their policy to make relatively modest grants to a wide number of applicants, which tend to be in the range of £500 - £3,000 but can be, exceptionally, as high as £5,000. The total annual income at their disposal is approximately £100,000.

Applications should be submittedby 5pm on 20th June 2016. Applications received later than this time will not be considered.

Completed applications forms should be emailed (see below) in Word format and supporting documents (Annual accounts, safeguarding policy etc) should be attached as PDF files or sent by post. In the case of an application from a local branch of a national charity, the local accounts should be submitted. Liverpool Charity & Voluntary Services (LCVS|United Way), who are administering the grants programme, may contact applicants for additional information.

Grants to eligible charities are determined by the Governors at an annual meeting held each summer. After the meeting applicants are notified in writing of the decision of the Governors.

Application forms and guidance can be downloaded HERE and completed forms should be emailed to . The postal address for supporting documents only is Skelton Bounty Grants Programme, LCVS, 151 Dale Street, Liverpool, L2 2AH. Tel. 0151 227 5177

When to apply: Completed applications must be received before 5pm on31st May 2017. Applications are considered at the annual general meeting in Mid-July.

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