Mummy's Star Grant Application

Mummy's Star - Grant Application Form
PLEASE NOTE BEFORE STARTING YOUR GRANT APPLICATION
Due to the Covid 19 outbreak and its impact on our operation,
the maximum grant that can be applied for is £250.

VIEW GRANT APPLICATION GUIDELINES
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

Town County

Postcode
Email *
example@example.com
Contact number *
Date of birth *
dd/mm/yyyy
Are you completing this form for someone else? *
Please tell us about your situation *
Please explain to us what you would like a grant to pay for? *
Please describe the benefit this grant would bring to you and your family? *
Grant expenditure. Break down the costs you have indicated in the previous answer.

Please list the items below for us. Include either the service you require and its total cost (eg. Cleaning hours £100), or list any individual items and their total cost (eg. Car Seat £150). Please only add one item per box below. Thank you.
Item 1 - Description and cost
Item 2 - Description and cost
Item 3 - Description and cost
Item 4 - Description and cost
Item 5 - Description and cost
Item 6 - Description and cost
Total expenditure of all the items applied for in your grant application *
Please note: if your application is successful then you are agreeing to use the grant for the agreed purpose within a 12 month period. Any change in the planned use of the grant must be agreed prior, by notifying Mummy’s Star in writing via email or otherwise. Any proposed changes will be dealt with as quickly as possible.
Payment details*

Details for payment of an approved grant by BACS/cheque
Name of account holder/made payable to

First Name Last Name
Bank name
Bank address

Street Address

Street Address Line 2

City County

Postcode
Account number
Sort code
International bank account number (IBAN)
Bank identifier code (BIC)
Information to support your application

Browse Files
You can attach pdf, doc, docx, jpg, jpeg, png, gif as acceptable formats. Cancel of
How did you hear about Mummy’s Star? *
Contact preferences

Our promise:
- We will only contact you with support information.
- We won’t bombard you with emails.
- We will never share your information with other organisations to use them, unless we are required to by law.
- You can change your mind at any time by emailing info@mummysstar.org
- We will hold your email, postal address, phone number and other communication details on our database until you tell us not to.
Support contact preferences. We will only contact you where necessary to provide the appropriate support to your individual situation. Please indicate how you would like us to contact you. We will only contact you in the way you want us to. *

Email Post Telephone Text None
Your consent *

By ticking this box, you've agree that we may use that Special Category Personal Data to provide you with tailored support and information and as further described in our Privacy Policy.
Completed application signed by *

First Name Last Name
Date of completed application *

Day Month Year
Date
Please verify below that you are human, and then please press the SUBMIT button. You will then receive an email confirming that your application has been safely received by us, and the same email will also contain a copy of the information that you submitted to support your grant application. Thank you. *
Should be Empty:

Mummy's Star - Grant Application Form

Grant expenditure. Break down the costs you have indicated in the previous answer.

Payment details*