Name of your organisation:*

Name of the person applying on behalf of the organisation:*

Grant amount being requested (Up to £3000; typical grant awards are £500-£1000):*

Purpose and object of your organisation [100 words max]:*

Purpose for which the grant money will be used [100 words max]:*

Does your organisation have its own premises?*

Does your organisation's premises allow for the sale of alcohol?*

Your email address:*

Telephone no:*

Details of the account any approved grant monies should be transferred to:
Account holder's name:*

Sort code:*

Acc. No:*

Name of Bank / Building Society:*