Our purpose is to unite people and planet

Voices for the Earth Community Trust

Application Form

For people whoare Voices for the Earth Community Trust andwish to benefit from our charitable status for funding or other agreed purposes

Part 1: name and contact information

Name:

Address:

Postcode:

Tel:

Email:

Web:

Part 2: Promoting your work and the Data Protection Act

We require your permission to use and store the information provided on these forms because we are required to report on your work to the Charity Commission and in our Annual Report.

I agree to this information:

being stored electronically yes / no

being shared by ECT to report on its activitiesyes / no

being shared on the ECT websiteyes / no

Part 3: General Information

How we can help you

We can provide a supporting bank facility where:

a) you have a funder that is a UK taxpayer;

b) your funders gift is to be treated as charity tax deductible in the UK; and

c) you do not have existing charitable status.

If all of the above applies, and your purpose and values align with ours, we invite you to join us and become one of the Earth Community Trusts Voices for the Earth.

Please be aware, the Earth Community Trust does not provide funding – what we do do, however, is give you the benefit of using our charity as a conduit charity for your UK funder.

This section is asking about you.

1. please describe who you are (we are not asking about your job title, we want to know about what matters to you)

2 please give a brief description of how who you are shapes what you do (eg ‘my love for the Earth has led me to my decision to become a voice for the Earth etc’).

3. How do youembody Earth Community Principles and Purpose?

4. Do you have anyone helping you?

5. Do you have a formal structure? eg. not-for-profit company / self-employed/ other

6. If you are leading a group or team, how many people are involved?

7. What can we do to help you?

8. If you need volunteers, what help do you need?

9. Do you or your team publish an E-newsletter/post on facebook/use twitter or other social media? yes / no (If yes, please provide links)

10. Do you or your team run a membership scheme? Yes / no (If yes, please enclose details)

12. If you or your team runs training courses, please describe them:

Part 4 A description of your work

A brief outline(with links if online):

Timescale(if applicable):

Other general things you want to tell us about your work:

Earth Community Trust – our charitable objects

Please confirm you agree to the following: yes / no

1. To promote the conservation protection and improvement of the physical and natural environment with particular reference to permaculture, bio-dynamics and with a view to helping people connect with nature;

2. To advance the education of the public in the theory and practice of holistic living.

(ECT Trust Deed 2011)

Part 5: Meeting the criteria of Education and/or Awareness 5a: if you are applying as an EDUCATION project

Describe the education/training activities that you will provide:

(If you have a proposed schedule of work or detailed project description online, please enter a link.)

5b: if you are applying as an AWARENESSproject

Describe awareness raisingthat you will undertake:

(If you have a proposed schedule of work or detailed description online, please enter a link.)

Part 6: Earth Community connection, your values and mutual benefit

The Earth Community connection

How does your work relate to connecting people to nature and/or holistic living?

Your Values

Do you/your team share the same values as us? Please list your values

Public Benefit

How does your work benefit the public?

ECT Benefit

How will the ECT benefit from your work?

Please add information about how your project will be socially relevant (where US funds are being sought)

Part 7: Project Declaration

I the undersigned agree that I will:

Only use the ECT name for funding purposes.

Provide a report of funding received using the ECT’s Charitable Status.

Not undertake any activities which are illegal, unethical, unhealthy or dangerous, or that could lead to causing harm or injury to you and/or others.

Take responsibility and accept liability for all activities undertaken as an ECT Voice, and make sure that appropriate insurance policies have been secured, and other statutory requirements covered.

Not enter into any agreements, contracts, applications for planning or any other legally binding agreement in the name of the ECT without prior consent and written permission from the trustees of the ECT.

Shall undertake my own fundraising.

Use the ECT name only for fundraising purposes that require charitable status.

Uphold the ECT’s purpose.

I have read the terms and conditions and agree to abide by them.

I understand that if any of these requirements are not met, then my use of ECT Charitable Status may be terminated, and that the CEO and/or the Trustees reserve the right to terminate this agreement with or without notice, and that their decision is final.

Print Name:

Signed:

Date:

On completion email the form

Your banking details

Account name:

Bank:

Bank address:

Account number:

Sort Code:

IBAN:

SWIFT:

APP 1: Record of decision

Applicant name:

Application received on: //Application complete: yes / no Signature sheet received and correct: yes / no

Application accept/reject send date: //

Decision maker name:

Any declaration of interest in this application? yes/no

If yes, what:

I support this application, for the following reasons:

I do not support this application, for the following reasons:

Do you recommend re-application? yes/no If yes, what is needed in addition?

Signature:

Date:

For office / record of decision and follow up action

Individual name:

Application received on: //Application complete: yes / no Signature sheet received and correct: yes / no

Application accept/reject send date: / /

Decision maker name:

Decision

ACCEPTyes / no Acceptance letter sent

yes / no Charity status terms and conditions sent

REJECTyes / no Rejection letter sent, with reasons

Summary of reasons:

REAPPLICATION ENCOURAGED?yes / no

What further work needed for reapplication:

(note: where values are not in alignment with the ECT, reapplication is not applicable)

Information added to:

yes / no website

Earth Community Trust, UK registered Charity 1143660, Voices for the Earth Application Form updated 3.17