Midsomer Norton Town Council

Office Use
Cat:

GRANT FUNDING APPLICATION FORM

Name of project:
Name of organisation:
Address of organisation:
Phone number: / Post code:
E-mail address:
Website address:

1) Details of organisation delivering the project:

2) Details of the main contact for this application:

Contact name:
Position in the organisation:
Address for contact person (if different to above):
Phone number / Post code:
E-mail address

3) About your organisation:

3.1 What is the structure of your organisation?
Informal group o
Registered charity o Please give the Registration Number: ………………………………
Other o Please give details below
………………………………………………………………………………………………………
………………………………………………………………………………………………………
Please include a copy of your organisation’s constitution or rules with the application
3.2 What are the aims and main activities of your organisation?
Please include a copy of your organisation’s Child Protection Policy (if appropriate) and Equal Opportunities Policy.

4) Details of project:

4.1 Please give a brief description of the project
4.2 What stage are you at with the project? When do you hope to start and how long will the project take?
4.3 What would the grant funding be used for and when?
4.4 Who will benefit from this funding and how will they benefit?
4.5 How will the project support the aims of the Community Grant Strategy? (Details are on the first page of the MNTC Community Grant Policy)

5) Funding

5.1 How much money are you applying for from the Town Council?
5.2 How much will this project cost in total?
5.3 Please tell us about how you are funding the project. For example how much you are providing yourself, and how much is coming from grants and loans (have these been approved?). Please tell us about any work you are doing yourselves.
5.4 Is the grant going to be used for an on-going project/ If ‘Yes’ how are you going to maintain it?
Yes o No o
Please include a copy of your organisation’s plans for the next 12 months (if the application is for less than £5,000) or three years (if the application is for £5,000 or more) .

6) Payment of the Grant.

Payment will be by cheque. Who do we make the cheque out to? Please give the account name below
Account name:

7) Your organisation’s financial position

Before awarding a grant the Town Council has to be sure that your organisation will be able to finish the project. The strength of your financials is a key consideration.
Please attach copies of your accounts and balance sheet for the last two years (or as many as possible if a new organisation). Similarly we need to see copies of the three most recent bank statements.

Please send your completed application form, signed and the necessary supporting documents – there is a checklist at the end of the form- to:

Clive Stilwell

Town Clerk

Midsomer Norton Town Council

Council Offices

The Town Hall

The Island

Midsomer Norton

Bath BA3 2HQ

Signed: ……………………………………..

Date: ……………………………………..

On behalf of (Organisation): ………………………………………………………….


Supporting information checklist

Please ensure that copies of the necessary documents are sent with your application (accounts and bank statements must always be submitted).

Tick to confirm enclosure
Group constitution or set of rules
Child Protection Policy (if appropriate)
Equal Opportunities Policy/Statement
Evidence of planning permission (if necessary)
Quotes for capital items and works over £500
Either:
1)  Twelve month forward plan for activities and finance applications for £5,000 or less
2)  Business plan for the next three years – applications over £5,000
Copies of the most recent/audited accounts (2years)
The three most recent bank account statements