Whixall Parish Council
Grant Application Form
Organisation Name
*
Your Name
*
First Name
Last Name
Your role within the Organisation
*
Address for Correspondence
Street Address
Street Address Line 2
City
County
Postcode
Email
*
example@example.com
Phone Number
*
Briefly explain what your organisation does
*
Charity Number (If applicable)
Amount of Funding Applied for
*
If you are applying for funding towards a one-off project, what is the total project cost?
If you are successful, how will the funding be used?
*
Approximately how many people will benefit from the work of your organisation?
*
What proportion of these people live in Whixall parish?
*
How will these people benefit?
*
Please confirm the following
*
I am authorised to apply for this grant on behalf of the organisation named above
I have included the last full year's audited accounts
I have included details of the costs of this project
I will provide a short progress report to the Council, outlining how the funding has been spent.
I understand that details of successful applications may be published on the parish council website.
Organisation's bank account name
Sort Code
Account Number
Signature
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