Grant Application Form

Please refer to the Grants Guidelines when completing this application. Applications can be made at any time of the year providing funding is available. All sections of this form must be completed. Failure to fully complete the form will result in rejection of the application. Applicants are advised that this form and the information contained in it will be included as part of the Town Council’s public records.

Section 1: Organisation Details

Name of Applicant Organisation:
(Required)

Project Name:

Project Location:

Project Start Date:

Project Completion Date:

Total Cost of Project:

Funding Requested:

Contact Name:
(Required)

Registered Charity Number
(If Applicable)

If No, state type of organisation:

Organisation Address:
(Required)

Email Address:
(Required)

Telephone Number:
(Required)

Organisation’s bank account address:

If your application is successful, to whom would you like the cheque payable? (Required)

Please provide the following information:

A location plan or site plan, if applicable

Copy of organisation’s latest certified accounts

Copy of constitution or set of rules

Evidence of any permissions or consents

Section 2: Budget Details

Costs:

Please provide a breakdown of the costs of the project

Item

Cost (£)

VAT (£)

Total (£)

Total Costs:

Extra Funding:

Please tell us about any other funding that you might receive for this project. Have you applied for funding in respect of this project to any other organisation (including Local Authorities)? Please give details of to whom and for how much.

Amount applied for

Outcome of application (or date when outcome will be known)

Hampshire County Council

Test Valley Borough Council

Testway Moneybox

Town or Parish Council

Please state which Town or Parish Council

National Lottery

Please state which fund

Other (please provide details)

Section 3: Grant Proposal

Description of Activity
Please provide a brief description of the activities to be funded by the proposed grant.

Details of Activity
Please provide additional details in support of your application, including why the grant is needed.

Please provide a general description of the people in Andover who will benefit:

Approximately how many local residents will benefit?

Your financial Situation:

All applications must be accompanied by the following financial information. If you do not supply this information your application will not be considered.

A copy of your latest approved statement of income and expenditure or other financial report which indicates your financial position

Photocopy of bank statements covering the last year

A statement of your capital assets if any

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Please note: By sumbitting this for you hereby certify that the information supplied in this application is correct and confirm that any grant awarded by the Council will be spent only on the purpose for which it was given.

info@andovertc.co.uk

01264 335592