GOLD / SILVER AWARDS
APPLICATION FORM - Please complete by hand or by computer
Organisation name & address
What type of organisation are you?YesNo
Voluntary and community organisation
School
Other
Community Interest Company
Partnership
Organisation details (If partnership, please give the Lead/Host organisation details)
Charity number (if applicable)Company number (if applicable)Registration number
When did your organisation start? dd/mm/yy
How many people are on your organisation’s governing body, management committee or board of directors?(If partnership, please list all partner agencies below)
Main contact for your organisation (this MUST be a member of your group)
Title / ForenamesSurname / Position in organisation
Address
Postcode
Email / Best contact number
Shall we write to you at your home address or organisation address?
What is the name of your project? (up to 10 words)
When will your project start? dd/mm/yyWhen will your project finish? dd/mm/yy
What type of award are you applying for in this application? (Please tick)
Gold / SilverWhich of the four outcomes does this scheme meet?
Outcome No. / Description / Please TickSocial Housing Tenants feeling less financially excluded through improved access to appropriate bank accounts, credit services, insurances or savings opportunities.
Social Housing Tenants who feel more confident to manage their money or to access mainstream financial services.
Social Housing Tenants who have attended financial management skills training
Social Housing Tenants who have attended financial accredited training opportunities.
How many? Please read section 7 (Tenant Engagement) ofGuidance Notes carefullyfor minimum numbers to be engaged
Please read section 7 (Tenant Engagement) of Guidance Notes carefullyfor minimum numbers to be engagedPeople do you expect to be involved in delivering the project? / Please note minimum numbers for Gold & Silver
People do you expect to take part in the project?
Other organisations / groups will you link with?
What project or activities do you want us to fund (up to 350 words). Be specific about what you want to do and what you will spend the grant on.
How much will your project cost?
Item or activity / Amount requested from MCS / How did you work out this cost?Totals
What is the change or difference that your project or activities will make? (up to 300 words) Gold projects – please add up to 150 words to tell us about you will ensure the sustainability of the activities
Making a DifferenceSustainability
Financial Information
What are the names and roles of the people in your organisation who are authorised signatories for payments (for example, BACS, online payments, signing cheques)?How many are needed to authorise a payment or sign a cheque?
Are any of these people related, in a relationship or living together?
(please tick) / Yes / No
If yes, please give details.
How will you promote and publicise your project? (up to 150 words)
PromotePublicise
Any additional information? (up to 150 words)
References: Please supply the names and contact details for 2 referees
Referee 1 / Referee 2Name: / Name:
Job Title (if applicable): / Job Title (if applicable):
Address: / Address:
Postcode: / Postcode:
Tel. No: / Tel. No:
Email: / Email:
Supporting documents
Have you kept a copy of this application for your records?Do you have a copy of your governing document that you can submit if successful in this application?
Does your governing body or management committee know about this application and agree that you can send it to us?
Does the named main contact have authority to apply for this award on behalf of your organisation?
Signed: / Position: / Date:
Please try to keep to the word limits given. If you are completing this form in Word then you can expand the boxes to fit your answer. If you are completing this form by hand, please continue on an additional sheet if required – please mark this additional sheet clearly with the name of your organisation.
1 | SFSH Money Champions Scheme Gold/Silver Application Form JF-P September 2014