GRANT APPLICATION FORM

NAME OF APPLICANT ORGANISATION

AMOUNT REQUESTED

Registered Charity No (if applicable):

Please advise previous numbers if changed within the last five years

Year established

Main Contact Name

First NameLast Name

Address for correspondence

Street Address

Street Address Line 2

CityCounty

Postal

Phone Number

Area CodePhone Number

E-mail address

example@example.com

Website address

KEY PURPOSE OF GRANT

Please describe briefly, but specifically, how you expect to use the monies granted for the benefit of those in need, in the Norfolk and/or Suffolk area. Please see our website for definition of ‘those in need’.

AIMS AND OBJECTIVES

Please state, in plain English, what the aims and objectives of your organisation are and briefly outline the activities and services you provide?

Please state how you FIRST came to hear of the Kerrison Trust

PERSONNEL

How many paid personnel does the organisation employ and for how many hours each week?

VOLUNTEERS

How many hours do volunteers work for the organisation each week?

THE PURPOSE OF YOUR GRANT

Please include what you want the grant for and why it is needed at this time. Outline what you hope to achieve with any grant and over what timescale.

What is the total cost of the proposed activity/project.

When is funding required?

Have you made applications for grants to any other bodies or organisations? If yes - What responses have you had?

MONITORING AND ACCOUNTABILITY

What measures do you have in place to ensure the grant is used well?

What documentation will you provide to show how the grant was spent?

Upload files here

Please describe (briefly) where you identify/find the young people thatyou help and/or how they are referred to your organisation.

Terms and Conditions
• The grant is only for the activity or project agreed by the Board of the
Kerrison Trust. A formal request is required if any changes are to be made.
• An evaluation report on how the grant has been spent, and what has
been achieved, will be required by the Kerrison Trust after six months,
or such other period as may be agreed.
• Grants are to be repaid to the Kerrison Trust if they are found to have
been spent fraudulently or negligently.
• Up to date records and accounts must be kept showing how the funds
have been spent. The Kerrison Trust reserves the right to inspect these
records at any time.

Declaration:
To the best of my knowledge and belief, all the information given above
is wholly correct.

I First Name Last Name am an authorised representative of

blanks (Name of Organisation)

blanks (Position in your Organisation)

Signature

Date

Privacy statement. Should your application be successful then this
document will be kept on file at the offices of the Kerrison Trust
and used only for the purpose of granting a donation and follow
up contact. Should this grant application be unsuccessful then all
paperwork will be destroyed by this office.

Note: Should you be successful we will require your Bank Details
and authorisation from your organisation Treasurer or Financial
Officer that these are the correct account details for the grant
to paid to electronically.

Trustees: Janie Spring | Diane Cook | Sara Michell
Anthony Holliday | Jacki Forsyth | Simon Bird | David Goodin
Registered Charity No. 228590.
Telephone: 01379 678599
Email: office@kerrison.org.uk
Registered office: 1 James Court, Whitefriars, Norwich NR3 1RU

www.kerrison.org.uk