Community Wellbeing PGM Application Form

Community Wellbeing PGM
Application form
Data Protection & Privacy Notice
To continue with this form, you must confirm that you have read our Data Protection & Privacy Notice, and consent to tsiMORAY storing the data as detailed within the policy.
You can access our Data Protection & Privacy Notice by following this link.

Organisation/Group Details
Managed Fund
Managed Fund Request Name
Organisation / Group Name*
Organisation / Group Legal Status*
YesNo
Organisation / Group Address*
If you do not have a registered address for your group/organisation please type 'Not Applicable'.
Organisation / Group postcode*
If you do not have a registered postcode for your group/organisation please type 'Not Applicable'.
Charity or Ltd Company Number (if applicable)*
If you do not have a Charity/ Ltd Company Number, please type 'Not Applicable'.
Please provide a brief description of your organisation/group (maximum 100 words)*

0/100

Project Description
What will you do or develop in your project? (maximum 150 words)*

0/150
What change or difference will this make? (maximum 150 words)*

0/150
How will you know? (maximum 150 words)*

Groups awarded a small grant will be supported to fill out an Evaluation Action Plan to gather evidence about the difference your project makes for people in your community. 0/150
Most voters are likely to make their decision about which projects to support on the basis of the summary you provide here.

Please make sure you capture the essence of the project and its impact below. We will add key financial information about your project separately, so no need for you to include that in your summary
Please provide a summary of your project. (maximum 30 words)*
Please provide a project timeline including a start date, end date and duration.*
What is the total amount of funding being requested?*
Please provide a project budget here, including items and cost.*
You may also submit a separate project budget sheet with your application but it is NOT mandatory.
What else might you need for your project? This could be access to advice, equipment, transport, venues or things that money can't buy.
Please type 'Not Applicable' if this does not relate to your application
Is there anything that you could offer to groups? It may be that you have equipment you could share, advice you could give, support you could offer, access to a venue etc,.
If you are unsure, please type 'Not Applicable'.

Declarations

PLEASE NOTE: All applicants will be required to complete the following section:
Please type your name here. This will act as your signature prior to submitting your application on behalf of your organisation.*

First NameLast Name
Please insert the date on which you are submitting your application.*

DayMonthYear
Guarantor information

This section only needs to be completed by unconstituted groups who do not have a bank account. Please provide details of your guarantor below:
Name of Organisation
Guarantor Contact Name

First NameLast Name
Guarantor Email address
example@example.com
Completing Your Application
Although not required, you are welcome to upload any documents which you think are relevant to your application.

All documents must have your organisation's name in the file name so that we know which files relate to which applications. If you require any further information please contact: Funding@tsimoray.org.uk

Closing date for applications: Monday 21st November 2022.

Good luck!
Please upload any other relevant documents here.

Cancelof
Should be Empty:

Community Wellbeing PGM