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1. Personal Information

Name of Applicant*

Name of Organisation*

Type of Organisation*

Charity No*

Company No*

Company Address*

Postcode*

Name of Contact*

Job title of Contact*

Tel No (switchboard)

Tel No (direct dial)

Mobile No

Email*

Names of Committee

Members / Trustees

No of Employees

Part / Full time

Paid / Unpaid

Volunteers

Total Annual Salary

2. Project

Title of Project*

Brief description of Project (maximum 400 words inc. costs/expenditure)*

Project Details

Purpose of Project (in less than 100 words inc. any deadline for delivery)*

Please state how you believe the Project will benefit the public (in less than 100 words)*

Length of Project*

Amount of funding being requested from the Foundation*

Under £2000
Over £2000

Please include the exact amount of funding being requested (£)*

Will any of the funding be used to meet your organisation’s core operational costs?*

Yes
No

If yes, how much? (£)

Total cost of Project (£)*

Do you wish the Grant to be paid directly to your organisation?*

Yes
No

If no, to whom would you like the grant to be paid?

Without the Grant, would the organisation be able to carry out the Project?*

Yes
No

Does your organisation have adequate insurance in place to enable the Project to be carried out in a safe and competent manner (this includes having insurance to cover the health and safety of anyone involved in the Project)?*

Yes
No

Does your organisation agree to acknowledge the Foundation and the Grant in any publicity material relating to the Project?*

Yes
No

Does your organisation agree to submit a report or reports demonstrating what progress has been made on the Project and allow Trustee visits to the Project? (In certain cases, future instalments of grant payments will only be made upon receipt of a satisfactory progress report)*

Yes
No

Please add a constitution document, if one is available

Drop files here or

3. Accounts Information

Please provide details of your main funding / income streams*

Please provide details of your core operational costs*

Please provide details of any significant project costs in the last two years*

Please supply detailed accounts for your last financial year and current year to date (these should include income and expenditure by funding type and an opening and closing balance sheet) Files can be uploaded below.*

File Uploads

Drop files here or

Please confirm any applications you have under review*

Please provide details of any regulatory / accreditation bodies that the charity is a member of*

Is the charity up to date and compliant with all necessary regulations and legal requirements including insurance, health and safety, taxation, company law and charitable entity status*

Yes
No

Are all employees’ / volunteers’ coaching, first aid and DBS training up to date?*

Yes
No

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LGA Foundation Application for a Grant

1. Personal Information

2. Project

3. Accounts Information

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