Yorkshire Common Application Form
1. Name of Organisation/Group
*
2. Address
*
Street Address
Street Address Line 2
City/Town/ Village
Website/social media
Postcode
3. Details of contact person
*
Title
Name
Position
4. Main contact number
*
5. Second contact number
6. Email
*
example@example.com
7. Do you have any communication needs? (e.g. BSL, large print)
By entering information in the box above you give your consent for [name of funder] to hold this information. See Privacy Notice for more details.
8. Please select your organisational structure
*
Informal group/community group
Registered charity
Charitable Company limited by guarantee
Community Interest Company (CIC) Limited by guarantee
Charitable Incorporated Organisation (CIO)
Community Benefit Society
Other
9. If you selected other, please describe
10. Please provide registered number(s) (charity/company etc)
11. Please briefly tell us the aims of your organisation and what you do (up to 300 words)
*
0/300
12. Please tell us the number of:
*
Number
Trustees/directors/committee/governing body members
Full-time and part-time equivalent staff
Volunteers (excluding those listed above)
13. Please describe the project, service or activity you are asking us to fund (up to 500 words)
*
0/500
14. Why is this project, service or activity needed? (up to 300 words)
*
0/300
15. Who will benefit from this project, service or activity? (up to 100 words)
*
0/100
16. How many people do you think will benefit from your project, service or activity?
*
17. Where will your project, service or activity take place: region, local authority, city, village, ward?
*
18. What difference will your project, service or activity make to the lives of those who take part? (up to 300 words)
*
0/300
19. When do you expect the project, service or activity we are funding to start?
*
-
Day
-
Month
Year
Date
20. When do you expect the project, service or activity we are funding to end?
*
-
Day
-
Month
Year
Date
21. How will your project, service or activity help to meet our aims/priorities?
*
0/100
22. About Money - please tell us what your project, service or activity will cost
Amount
Total project/service/activity cost
How much are you asking us for?
23. If you are asking for less than the total project/service/activity cost, please tell us where the rest of the funding is coming from and when you hope that will be secured
24. Budget for project/service/activity
*
Item
Amount
Description
1
2
3
4
5
6
7
8
9
10
Total
25. Please tell us what you think your income will be for the current financial year
*
26. Please tell us what you think you will spend in the current financial year
*
27. Is there anything else you want to tell us about your finances going forward?
28. Amount of current unrestricted/free reserves
*
29. Does your organisation have a bank account?
*
Yes
No (please describe below who will hold the funds you have requested)
30. If your organisation does not have a bank account, please explain who will hold the funds you are requesting
31. Name of bank account
32. Name of bank/building society
33. Bank account number
34. Bank sort code
By signing this for you are confirming 1) You are authorised to make this application on behalf of your organisation 2) The information provided is accurate and true 3) Your application has been authorised by the governing body of your organisation
Please upload these supporting documents 1) Most recent, audited or authorised statement of accounts 2) A copy of a recent bank statement 3) A copy of your organisation’s Safeguarding Policy if your work involves children and young people or vulnerable adults 4) A copy your governing document/constitution 5) Include photos and any additional documents you feel show the work you do
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