PATCHAM COMMUNITY FUND

APPLICATION FORM

1. Name of group/organisation (Charity Number (if applicable                )

2. Address

3. Contact Name & Telephone Number

4. Project/purchases for which funding is required

5. What benefit will this bring to the Community

6. Total Cost of Project/purchases  £

7. How will your part of the total cost be funded

8. What sum would you like the Fund to provide £

Please note that if appropriate, we will need to see your latest set of accounts and/or ask for further information regarding your financial position.

We have kept the information requested at this stage to a minimum and our final decision may be dependant on a meeting with you/ your committee to discuss matters further.

Please do send any additional information that you may feel will help us with our initial decision.