Easton-in-Gordano Pill & Ham Green Community Forum
EITHER – Cut and paste this form -> Complete it -> Post it to Secretary, Liz Moore, 3 Lodway Gardens, Pill, BS20 0DL or email: email@example.com
|Contact Name _________________________________________________
Contact Address ______________________________________________________
Telephone number ________________ Mobile______________________________
Email address _______________________________________________________
Bank details _________________________________________________________
Cheque payable to ____________________________________________________
|Please tell us what you need funding for, who will benefit and how they will benefit relating your application to a specific item in the Parish Plan Action Plan
Funding for _________________________________________________________
Who will benefit? _____________________________________________________
Benefit related to Parish Action Plan _______________________________________
|Total cost of the project £__________________
How much required from the Forum£ _______________
Other sources of other funding£ ___________________
I confirm that, to the best of my knowledge and belief, all the information in this application is true and correct and I agree to conditions noted below.
Recipients of grants from the Community Forum agree:
- To provide a short written account of the implementation of the project and its impact on completion.
- That any funds allocated to this project will only be released on submission of appropriate evidence of expenditure and that any money not spent within 12 months of the date of approval by Forum will be returned to the general fund.
- That any funds allocated will only be spent on the purposes outlined in the application submitted. If there is a need to change the purposes, a revised application must be made to the Forum.
- If financial support by the Community Forum beyond this deadline of 12 months is hoped for, a further application will need to be made. Early notification of the need for such continued support is advisable, if it becomes likely.
- If it becomes clear significantly before 12 months have elapsed that expenditure on the project has ceased, the treasurer of the Forum should be informed so that funds are available for use in other ways.
- That any equipment purchased using a grant from the Community Forum will be made available to other groups within the community that have an appropriate use for it.
Please return your completed application form to:
Secretary: Liz Moore, 3 Lodway Gardens, Pill, BS20 0DL firstname.lastname@example.org
Note: electronic versions of the completed form are preferred. If you are able to insert a scan of your signature at the relevant point, please do so. However, applications with typed signatures will be accepted, provided they come from the email address of the person signing the application.
Secretary: Liz Moore 01275 375091 email@example.com
Forum Treasurer Maddie Bickle, 373357 firstname.lastname@example.org