Community Support Application Form

Application Form

for community grant up to £250
Name of organisation *
What does the organisation do?*
In which parish(es) does the organisation operate?*

Aveton GiffordBuckland tout SaintsCharletonChillingtonChivelstoneChurchstowEast AllingtonEast PortlemouthFrogmore & SherfordKingsbridgeLoddiswellMalboroughSlaptonSouth HuishSouth MiltonSouth PoolStokenhamThurlestoneWest AlvingtonWoodleighAll 20 parishes above
Contact name*
Contact email address*
Confirm contact email address*
Contact telephone number*
Address of the organisation or the contact

Address

Address Line 2

Post townCounty

Postcode
Describe in no more than 100 words the project, event, equipment etc. for which funds are sought. (The grant is not available for a 'general fund'.)*
Who will benefit from this project, event, equipment etc..*

Children (12 years and under)TeenagersAdultsAdditional Needs/DisabledElderlyOther
Indicate the amount of the grant sought.*
What is the total cost of the project, event, equipment etc.?*
How will you fund the difference between the total cost and the grant, if awarded?*
When is the anticipated completion date of the project or date of the event or of the acquisition of the equipment etc?*

DayMonthYear
Date
Tick box to accept the Terms & Conditions*

I/we agree to the terms and conditions set out on the Rotary Club of Kingsbridge Estuary website, and in particular to take part in any future publicity relating to the grant.
Data policy*

I consent to details of my application being retained until a final decision has been made on my application. I understand that information provided in connection with this application will be kept confidential within Kingsbridge Estuary Rotary Club unless a grant is made when it may be used for publicity purposes.
A copy of this form will be emailed to you at the address you have given.
Should be Empty: