Ref
y-notts.org.uk
.
[email protected]
(0115) 9100838
PO Box 9065 Nottingham NG4 9BH
Registered Charity 224651
GROUP Funding Application Form
 Grants will be given on successful application, according to priority and availability of funds.
 Applications are accepted at any time throughout the year and the committee will study the application
within about two to four months, provided you have included all of the requested information.
 You may be invited to an interview as part of the process.
 It is strongly advised you read the guidelines carefully to ensure you meet the criteria for eligibility.
 NB We make one-off grants and do not fund projects ongoing.
1. CONTACT DETAILS
Title of main contact: Mr / Miss / Mrs / Ms Other:
Gender: Male / Female
First name of main contact:
Surname of main contact:
Main contact’s role within the organisation/group:
Contact details for correspondence.
Email:
Telephone number(s):
Address:
2. ABOUT YOUR GROUP/ORGANISATION
Organisation/group name:
When was your group set up?
What type of group are you?
Registered Charity (number__________________ ) /
Company Ltd by Guarantee (number ________________ ) /
Unregistered Group with Formal Rules / Other (please describe)
Where are you based (incl address and areas of operation)?
Group website:
Who does your group benefit? children / youth / young adults / other (please specify)
What does your group do (max 100 words)?
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3. ABOUT YOUR PROJECT OR ACTIVITY
Project name:
Project leader:
Briefly describe the project (max 200 words) eg who / what / when / where / why:
How do you know there is a need for this project?
Do you have an action/business plan? If so, please attach to this application.
When will the project start (approx.)?
When will the project finish (approx.)?
Address where project will run:
4. MATCHING THE CRITERIA
How does your project meet the criteria of this fund and how will people benefit (max 100 words)?
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5. FUNDING
What is the total cost of your project overall?
£
How much are you applying for here? (max £3,000 although more may be possible, depending)
£
Please list the breakdown of amounts totalling the amount requesting (insert rows or continue on extra sheet if needed):
Amount £
Item/Activity
£
£
£
£
£
£
£
Please list other grants or donations you have been awarded or are waiting to hear about (insert rows or continue on extra
sheet if needed):
Name of organisation/individual
Amount £
Status
Awarded / Denied / Awaiting Decision
Awarded / Denied / Awaiting Decision
Awarded / Denied / Awaiting Decision
Awarded / Denied / Awaiting Decision
Awarded / Denied / Awaiting Decision
Awarded / Denied / Awaiting Decision
Awarded / Denied / Awaiting Decision
6. FINANCE
Does your group have a formal set of annual accounts? Yes / No
If yes, please include a copy of your latest accounts with your application.
If no, please include a cash flow forecast for a 6-12 month period.
Does your group have its own bank/building society account? Yes / No
If yes, please include a copy of your latest statement.
Bank/Building Society Name:
Branch address:
Sort Code:
Account number:
Building Society roll number (if applicable):
Account name that payments should be made to:
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7. REFERENCES
Please provide details of 2 people that can vouch for you with at least 1 not linked with the group:
Referee 1
Referee 2
Name:
Name:
Job title:
Job title:
Connection to project:
Connection to project:
Connection to applicant:
Connection to applicant:
Email:
Email:
Tel:
Tel:
Address:
Address:
8. PUBLICITY
How/where did you hear about us?
9. DECLARATION
I am authorised to submit this application on behalf of the group and certify that the information enclosed is correct. By
submitting this application form I agree to abide by the terms and conditions detailed on any grant letter sent by y-notts. I
understand that I will be expected to monitor expenditure and provide y-notts with receipts and report on the progress of
the project/activity. I also give y-notts permission to record information given on this form electronically and understand
that personal information will be treated confidentially. This information will only be used for deciding upon a grant award,
customer care, publicity, and monitoring.
Signed by main contact/applicant (typed is suitable for email applications):
Date:
Please submit your application in one of the following ways:
1) Email Word or Rich Text Format documents to [email protected]
(NB You can email your application form and submit supporting documents by post if unable to email files or scan
and email papers as pdf or jpg)
2) Post (ONLY if email is not possible) to PO Box 9065, Nottingham NG4 9BH, hand written application forms take longer
to process
We will acknowledge receipt via email.
FOR OFFICE USE
Date received:
Forwarded to trustees:
Decision amount:
Applicant informed date:
Payment amounts and dates:
Date due to complete by:
Date actual completion:
Date sent End of Project Report:
Other:
Date file closed:
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