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Buttercrane Community Bursary Application Form 2011

1) Group, Organisation or Charity Name
2) Contact Name
3) Correspondence Address

4) Contact Details
Email:
Tel No:

If a registered charity please complete the following; (If not please proceed to Q9)

5) Charity Registration No. (if applicable)
6) Date established
7) Proof of legal status
8) Which category does the project fit within?
Arts Sports Health Environment 9) Please provide an overview of the project and the benefits that it will create for the community and/or group

10) Total cost of the proposed project:
11) Indicate the contribution amount you are applying for?
12) What are the start and finish dates for your project? Start Date Finish Date
13) If you are successful in your application, what will you spend the money on?

14) Would you be happy to participate in publicity?
15) Please give us some background information about your group or charity:

16) Who does your group or charity benefit?

17) Where is your group or charity based?
18) Do you plan to run any events in conjunction with the project? If yes, could the event be held at Buttercrane Shopping Centre? Please provide details

19) Please explain why you feel that your group or charity should receive this bursary:

20) Please advise if you have received or have applied for funding from other sources for this project.
Yes (Please provide details) No

I confirm that the organisation is non-profit making

Please refer to Award Scheme rules and criteria shown below.

Please Enter Code to Proceed *