Application Number: _____/16
Street Properties & Small Blocks
Application Form
Please answer all the questions and refer to the guidance notes. If you need help filling in this form contact a member of the Neighbourhood Management team (details at the end of the form)
SECTION A: ELIGIBILITY
In order to be eligible to apply for a grant from this programme, you must be able to answer yes to all the following questions (please highlight or circle)
Ø Are you a CHMP resident living in a street property or small block? Yes
Ø Have you checked the guidance notes to make sure your proposal is eligible for funding? Yes
Ø Have you spoken to your neighbours and are they in favour of your proposal? Yes
Ø Will the proposal benefit CHMP residents? Yes
Application Address:Brief description of your proposal (Maximum 25 words)
How much money are you requesting from us? £
SECTION B: ABOUT YOUR PROPERTY
What type of home do you live in? Please highlight or tick all that apply
· House
· Maisonette
· Converted house
· Purpose built block of flats
Number of residential units at this address: ______
What will the grant help you to achieve?
Will CHMP residents be involved in delivering or taking part in your proposal? Explain
how
Will residents contribute financially or make any other contribution to the proposal?
Please provide details and amounts of contribution (if applicable)
Please give details of how you have consulted with other residents and their response
When do you hope to start the proposal?
How many CHMP residents will directly benefit?
Applicant’s details: Please print
Name: ______
Address: ____________
Postcode: ______Telephone: ______
Mobile: (Optional) ______E-mail: ______
PLEASE SEND YOUR COMPLETED FORM TO:
Circle Housing Merton Priory
Neighbourhood Management Team
The Grange
1 Central Road
Morden
SM4 5PQ
Telephone: 0300 500 3000
E-mail:
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