Name of Organisation supporting the application:
Contact name in organisation:
Role:
Organisation address:
Postcode: / Contact email address:
Organisation telephone no:
Organisation website address:
Tick the one box which is most appropriate to the focus of organisation’s area of work:
Arts, Culture, Heritage Citizenship/Community Development Education
Environment Human Rights/Conflict Resolution
Prevention or Relief of Poverty Other Charitable Purposes
Please indicate if the structure of the organisation;
Charity registered with HMRC Charity Number______
Company Limited by Guarantee Company number______
Unincorporated organisation
Please confirm you have the authority of the Management Committee of this organisation to make this application by ticking this box
Please confirm you will account for this funding within your financial processes by ticking this box
Please confirm you will spend this funding in accordance with the budget and the agreement of the funders by ticking this box
This form is available in different formats upon request.
1. About this Organisation:
Please provide details of the organisation supporting your application, including a brief history, its core services,its staff and trustees, its alliances and its main achievements, particularly over the last two years.
2. About how this money will be reported and spent.
Please indicate how the funding will be allocated and accounted for within your financial systems. Please indicate how the funding will be spent.
Please confirm you have the following documentation and ensure this is included with the application.
Required documentation / Tick- A signed statement from the organisation who is supporting your application, that they support your application and are willing to receive and account for the funding from The Xchange, and to put it to the use agreed with the funder.
- A copy of this organisation’s latest business plan (it will not necessarily prejudice your application if you do not have one);
- An income and expenditure budget for this organisation as a whole for the current financial year (if the financial year ends in March this should be for both the years 2014/15 and 2015/16), showing which funding is secured.
- A copy of the most recently audited accounts – if these are more than 9 months old please let us have, in addition, management accounts or similar to the end of the calendar year 2015.
- A copy of your Constitution, Memorandum and Articles of Association or other rules (only required if you are not a registered charity).
Signature:
Organisation:
Date:
PLEASE RETURN THIS COMPLETED ORGANISATION APPLICATION FORM and required documentation,TOGETHER WITH THE INDIVIDUAL APPLICATION FORM and required documentation,
to: Rachel Cooley,
by19 May 2016