QUEEN MARGARET UNIVERSITY /

SANTANDERUNIVERSITIES

COMMUNITY AWARDS

APPLICATION FORM

Before submitting your application, please ensure you have a written reference from the charity on behalf of whom you are applying.

Name
Matric. No.
Charity Reference Attached? / Yes / No
Please give the name of your charity referee

Please complete this form digitally and submit to

Section 1 - About You

Your Contact Details:
First Name: / Surname:
Email: / Phone:
Address:
Postcode:
Your Current Studies:
Subject Area:
Programme of study:
I am:
(Please delete as appropriate) / A current Undergraduate student
A current Postgraduate student
Dates of Study at QMU:
From: / To:
(Projected)

Section 2 – Your Chosen Charity

Your chosen charity’s details
Charity Name:
Charity Address:
Postcode:
Website:
Registered Charity Number:
Name of Main point of contact at the charity:
Tel No:
E-mail:
Your relationship with the chosen charity
These awards are intended to support charities with which QMU students either volunteer or work. In no more than 250 words, please outline the nature and length of your association with the charity.
How does your charity support the local community
In no more than 750 words, please explain how your chosen charity interacts with and supports the local community.
If successful, how would the money be used by your chosen charity?
Please explain, in no more than 500 words, how your chosen charity intends to use the £500 award.

Section 3– Declarations

Declarations
I confirm that the information given on this form is true and correct to the best of my knowledge. (Any false statement may be sufficient cause for rejection of your application.)
Signed: / Date:
It is a condition of gaining Santander Universities funding that a 1000-1500 word report on how the money was utilised is submitted to QMU for feedback to Santander Universities.
Santander Universities also requests that some of your personal information be shared with them in order to confirm your position as one of their scholars. Should you be successful in your application, the information which may be shared with Santander is as follows:
-Full Name
-University e-mail address
-Start date and projected end date of your current programme
-Country of origin and legal nationality
-Details of the charity you are working with and the projected use of the money
Please sign below to confirm that you are happy for this information to be shared.
Signed: / Date:
Please type your name in the spaces provided above. You are not required to print the form.

Once completed please submit this form to:

Stewart Sands, Student President at

Deadline for applications:Monday 30th April @ 4:00pm

Thank you for your application.