Send Your Completed Application Form To

March 2017

/ Esgobaeth Llanelwy
Diocese of St Asaph
APPLICATION FOR A TRAINING BURSARY
Please refer to the Guidance Notes before completing this application form /
SECTION A
Title & Full name of applicant:
Daytime Tel.No:
Alternative or mobile Tel. No:
Email address (essential):
Address including postcode:
Please use this space to insert a heading that briefly describes the training/learning event/programme
SECTION B
Provide full details of your training/learning event/programme (please refer to the Guidance Notes for advice about how to complete this section)
SECTION C
Financial Details
Please provide a breakdown of all costs
Detail / £ cost
Total cost / £
How much of this cost would you like the Diocese to fund / £
Yes
No
Do you anticipate applying to other funders for a grant or bursary?
Funder / Amount Secured / Amount Seeking
£ / £
£ / £
£ / £
SECTION D
Please use this space to provide us with any other information to support your application. If there is insufficient space in this box, you may attach an additional sheet using no more than one side of A4 paper
SECTION E
ACCOMPANYING DOCUMENTS- Please indicate which documents are submitted with this form in support of your application
Invoice
Quotation
Accounts/Financial report/statement
Prospectus/course details
Other supporting document(s) – please specify nature of additional document
SECTION F
BANK DETAILS– please supply the details of the bank account into which the bursary should be made
NAME OF BANK
NAME OF ACCOUNT
SORT CODE
ACCOUNT NUMBER
SECTION G
SIGNATURE OF APPLICANT / DATE

SEND YOUR COMPLETED APPLICATION FORM TO:

Mrs Karen Williams,

Diocesan Grants Committee,Diocesan Office, High Street, St Asaph LL17 0RD

CLOSING DATES

The Diocesan Grants Committee meets four times a year to consider applications. The closing dates for the receipt of applications are:

30November for the January meeting of the Grants Committee

28 Februaryfor the April meeting of the Grants Committee

31 May for the July meeting of the Grants Committee

31 August for the October meeting of the Grants Committee

SECTION H
PLEASE LEAVE THIS SECTION BLANK - FOR OFFICE USE ONLY
Observations & countersignature of Diocesan Director of Ministry or Training Forum Co-ordinator
Is this application connected to a training need identified during the Ministry Development Review and recommended by the Bishop? / Yes / No
Signature / Date
Date received at Diocesan Office
Outcome
Applicant notified on

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