Lewisham Sports Small Grants Scheme
ApplicationForm

(Excel ‘Individual’ Stream)

Please complete this form with as much detail as possible to allow us to accurately assess your application for funding. Incomplete forms will not be taken forwards to the Assessment Panel.

Contactinformation (please print your details below)

Your name

Organisation/Club/Team name

Sport

Contact phone number

Contact email address

Contact address (including postcode)

Proposed costs

Total funding requested

(Up to £500)

Breakdown of funding spend (please itemise proposed spend)

What / When / Cost
i.e. transport, physio, equipment etc / Dec ‘14 / £100
Total Costs

How does this application meet the necessary funding criteria? (Maximum 500 words)

Please refer to the excel stream criteria and evaluation information – the more detail you provide the more likely that your application will be successful

Are you affiliated to, or a member of a National Governing Body of Sport?

YesWhat is your affiliation/membership number?

No

Please include all necessary evidence as described within the Evaluation Criteria on the Excel Stream Fact Sheet.(i.e. Letter from NGB etc)

Declaration

I declare that all information that I have provided in this application is true and that if successful I will abide by the awarding criteria/funding conditions as described by the funding body.

Name Date

______

Checklist

I have completed the application form fully

I have included all relevant information about how my application meets the funding criteria

I have included all necessary supporting evidence

I have kept a copy of my completed application for reference

Please return your completed application form and supporting documentation (or if you have any queries) to – by the 10 August 2014

Lewisham Sports Small Grant Scheme Application

Cultural and Community Development Service

2nd Floor Laurence House

Catford

SE6 4RU

Please note that:

1. It is your responsibility to confirm that your application has been received.

2. Incomplete application forms will not be taken forward to the judging panel.

The information you have provided us with will be used in accordance with the Data Protection Act 1998 and other relevant legislation. We have a duty to make sure you know what we intend to do with your information and who it will be shared with or disclosed to.

The Council may share the information you have provided us with amongst its own departments, this is to improve working practices and the delivery of services. We may also use it to contact you from time to time.

We may pass your information to other agencies or organisations as allowed or required by law, for example to enable them to carry out their statutory duties or where it is necessary to prevent harm to yourself or other individuals.

Please tick here if you do not wish to be contacted by the Council.