Grants and Free Use Application Form

Sender (hidden)

Organisation legal status*

Charity / CICNot-for-profitOther

Please note that only local charitable or not-for-profit organisations are eligible for grant funding. In the case of national or regional organisations, the request must clearly demonstrate that the funding is ringfenced for the benefit of the Henley community. Click here to read the grants policy information.

Deadlines:

Grants up to £2,500, including free use of facilities – The annual deadline for applications is 15 August for decision making in September and 15 February for decision making in March.
Grants over £2,500 – annual deadline 1 November for decision making in December.

Contact our Information Centre if you need help filling in this form.

Application type (use next field instead as applicants may apply for 2 options)

Free UseGrant up to £2,500Grant £2,501 to £20,000

Grant application type:*

Free UseGrant up to £2,500Grant £2,501 to £20,000

1. Applicant Details

Organisation name:*

Must be a charitable or not-for-profit organization.

Contact name:*

Contact telephone:*

Contact email address:*

example@example.com

Address:*

Street Address

Street Address Line 2

City

Post Code

VAT Registered?*

YesNo

Registered Charity / CIC?*

YesNo

Charity or CIC Number:*

Only for registered charities

Date organisation established:*

Enter 31 [Month] [Year] if the exact date is not available

Description of organisation:*

Do the organisation’s activities seek to make a positive impact on the environment?*

YesNo

Please give details of activities that seek to make a positive impact on the environment? *

The Town Council has a statutory duty to consider the effects of its decisions on biodiversity, and crime and disorder in the area.

Does the organisation itself adopt environmental policies for reducing greenhouse gas emissions and/or increase biodiversity?*

YesNo

Please give details of policies and aims. *

2. Financial Information

Select an option*

I am completing the form with financial information (8 boxes)I am attaching accounts showing the last 2 years

This Year End Date

E.g. 31 December 2024

Net Current Assets This Year*

This amount equals the Reserves

Net Current Assets Last Year*

This amount equals the Reserves

Current Cash Balance This Year*

Current Cash Balance Last Year*

Annual Income This Year*

Annual Income Last Year*

Annual Expenditure This Year*

Annual Expenditure Last Year*

Accounts attached (only add the SOFA and the Balance Sheet for the latest year)

The last set of accounts will usually include information for the last two years. Maximum 3 pages.

3. Grant details

Amount Requested:*

Reason for grant and summary of costs (including VAT):*

How will the grant benefit the Henley Community?*

Please specify predicted numbers of beneficiaries, if known

4. Other Grants

Details of any other grants applied for in relation to this activity / service:*

Enter None if no other applications have been made

Details of previous grant applications to the Town Council (inc. dates):*

Enter None if no other applications have been made

5. Key Application Dates

Date of application:*

Date

Date funding requested by: *

If ASAP, enter the date of the application

Estimated start date of activity:*

Enter the first day of the month if no specific day applies.

Estimated duration of activity:*

Confirm hours / days and add comments if necessary.

6. Bank Details

Sort code:*

Account Number:*

Account Name:*

7. Further details (grants of £2,501 to £20,000 only)

Are you applying for funding over multiple years (up to three)?*

YesNo

Are you applying for funding over multiple years (up to three)? If so, please specify. *

£___________per year over ________years

Have you attached your project plan and budget for the activity / service?*

YesNo

Project plan and budget for the activity / service (maximum 5 pages)

Please only add a maximum of 5 pages.

Can your organisation reclaim VAT?*

YesNo

For capital projects – who is responsible for maintaining the asset?*

Type NA if no capital project related

Is your organisation currently the subject of any legal dispute?*

YesNo

8. Free use details (questions 3 to 7 are not required for free use applications)

What will the free use room be used for:*

Number of expected attendees:*

How often will free use likely be requested?*

One off, once per week, per month, per year, etc

On what days and times will free use likely be requested: *

Free Use can only be offered at the Town Hall and the Barn, weekdays 9 am to 4:30 pm. Extra hours at the Town Hall only on Mondays, 4:30 to 10:30 pm and the Barn, Mondays and Tuesdays, 4:30 to 10:00 pm.

Contact details for bookings: *

Name

Further information (optional)

Maximum of 10 pages and including pages submitted on other areas.

Email

example@example.com

For more information or to submit your application, contact the Finance Manager on 01491 630070 or email finance@henleytowncouncil.gov.uk
Grant applications are determined by the Council during public meetings, and this application form will therefore appear in the public domain. If you do not wish for any of your personal contact information to be included in the public papers, please specify when submitting your application.
We will only use your personal information to contact you about your application, and other sources of funding that may be applicable. To find out more, you can view our privacy policy at www.henleytowncouncil.gov.uk.

I confirm that I have read and agree to the conditions within the grant and free use policy, and that the information given above is correct to the best of my knowledge.

Signature*

Name*

Date*

Date

Please verify that you are human*

GRANT AND FREE USE