Member's Petition Form
All fields on this form marked with a red asterisk are mandatory
Name of Member
*
First Name
Last Name
Role within the Charity
*
Email
*
example@example.com
Name of Charity
*
Charity Number
*
Charity Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Charity Website Address
*
Date Charity Established
*
-
Day
-
Month
Year
Applications are only accepted from charities established more than two years
Objectives & Purpose of Charity (in no more than 200 words)
*
0/200
Where does the Charity operate
*
Category - Please select the category of service provided by the Charity
*
Addiction
Homeless & Rehabilitation
Arts Enrichment
Children
Young People & Education
Food & Nutrition
Health & Wellbeing
DETAILS OF REQUESTED GRANT
Size of Grant Requested
*
Intended Purpose of Grant (in no more than 350 words)
*
0/350
Have you made a previous application for a grant to the Vintners’ Foundation? (Please give date and result.)
*
Please upload copy of your latest accounts
*
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