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Application Form for Grant Assistance. Please provide the following information to enable the Trustees to consider the eligibility for a grant.
1
Guidance Notes
2
The Applicant
3
The Grant
4
Other Information
5
Supporting Documents
6
Confirmation
GUIDANCE NOTES FOR APPLICATIONS
The Constitution of the Rycroft Children’s Fund states that its purpose is to give relief to children and young persons who are in conditions of need hardship or distress and who are resident in the counties of Cheshire, Derbyshire, Greater Manchester, Lancashire or Staffordshire. The Trustees of the Fund are unable to consider any application which does not fulfil those criteria.
In particular, the Fund is unable to fund general living expenses, educational expenses, housing cost such as rent or mortgage payments, or building repairs.
To establish that an applicant meets the Fund’s above criteria, applications will need to be accompanied by copies of documentation from an official agency confirming the circumstances of the applicant. Examples of such documentation include:-
Benefit statements
A letter of support from social or case workers, educational establishments, housing associations or charities.
A report of a consultant specialist, medical practitioner or qualified nurse, treating the applicant.
Applicant Type
*
Individual
Group
Association
Applicant Name
*
Mr
Mrs
Miss
Ms
Dr
Prof.
Rev.
Title
First
Last
Address
*
Street Address
Address Line 2
City
ZIP / Postal Code
Date of Birth
*
DD slash MM slash YYYY
Phone
*
Email
*
Name of Person to Contact
*
Full Name
If a Charity application, please provide Registered Number
Name
First
Last
Address
Street Address
Address Line 2
City
ZIP / Postal Code
Phone
Email
Purpose for which the grant is requested
*
Amount of grant applied for
*
Total cost involved
*
Amount to be provided from own funds
*
Amount to be provided or requested from other sources, both charitable and otherwise - please specify
*
Will any further amounts be required in the future? If so, please specify
*
If applicant has obtained medical or children’s services advice please provide written support of the applicant from the Medical/Health/Care practitioner involved, and Specialist Consultant if any
When is the grant needed?
*
DD slash MM slash YYYY
How did you hear about the Rycroft Children’s Fund?
*
Please provide any further relevant information that you consider might assist the Trustees in making their decision
To ensure compliance with the regulations of HM Revenue and customs, please confirm that for tax purposes you are resident in the United Kingdom
*
Yes
No
Supporting Documents
*
Drop files here or
Select files
Accepted file types: zip, jpg, png, pdf, docx, Max. file size: 128 MB.
Please upload all files here.
I confirm that all information provided in this form is correct to my knowledge and that I am authorised on behalf of the applicant to submit this application.
I agree to the terms of this application and have adhered to the Guidance Notes on the first page of this form
*
Print Name
Date of Submission
*
DD slash MM slash YYYY
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