The William Dudley Trust – Grant to Charities Application Form

The William Dudley Trust
Registered Charity No. 214752
GRANT APPLICATION FORM

Please type or write in black ink.

Section One: About Your Organisation

1. Name of Organisation:
2. Address of Organisation:
Address:
Postcode:
Tel.
Email:
Website:
3. Contact for this application:
Name:
Position in the organisation:
TelephoneNo. (Land line):
Mobile Phone No:
Email:
Contact address (if different from above):
4. If known, when was your organisation set up? / Month: Year:
5. Annual Turnover
(Must be less then £250,000 to be eligible to apply for a grant from The William Dudley Trust) / £ / IMPORTANT: You must attach a copy of your most recent accountswith this application.
6. You must be a registered charity to apply for a grant from The William Dudley Trust
Charity Number:
7. Your charity must operate within Birmingham to apply for a grant from The William Dudley Trust. Please confirm below that this is the case (delete as appropriate).
The grant being applied for will be spent within Birmingham: / Yes / No
8. What are the aims and objectives of your charity? What were you set up to do?
9. Describe the work your charity normally delivers.Please briefly describe current activities, the type of people who benefit (e.g. elderly people, children, families), where these activities take place, etc.
Section Two: About Your Grant Application
10. Please explain why a grant is needed and what it will be spent on.
The William Dudley Trust only gives money for specific purposes (e.g. an event, items of equipment, etc.) and does not donate to general unspecified requests for funds.
11. How much will the project/item(s) cost in total?
If the project or items costs more than the grant application how you will meet the extra cost? Please be as specific as possible. If other bodies are part-funding please say what parts they will pay for and what parts you are applying to The William Dudley Trust for.
12. How much grant are you applying for?
Grants will be awarded up to a maximum of £1000 for approved projects. Please make sure that the costs sought cover the proposed project activities and that they give value for what you are planning to do. An accurate estimate of these extras costs is required.

Cost of each item and how worked out

e.g. Room hire for6sessions @ £50 per session
e.g. Two microwave ovens @ £100 each / £s
e.g. £300
e.g. £200
1.
2.
3.
4.
5.
Total grant applied for:

PLEASE NOTE - Trustees will only use this form and the accompanying charity accounts on which to base their decision on funding. Any other correspondence or accompanying literature will NOT be considered.

13. Declaration by the person who has filled out the form:
I declare that all the information in this application is accurate to the best of my knowledge.
Signed: / Print name:
Position: / Date:

The William Dudley Trust

PO Box 17077, Birmingham B2 2NF

Email: info@ williamdudleytrust.org Website:

Supplementary Sheet

(for use only if additional space is required to provide information requested on main form)

Organisation: / Ref.:
(Leave blank)
Question
Number: / Supplementary Information:

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