APPLICATION FORM

 

 

 

PLEASE COMPLETE ALL SECTIONS OF THIS FORM

 

Organisation name                                        

Registered charity number (if applicable)     

Contact name                                                

Position                                                          

Postal address                                   

Daytime telephone number                           

Email address                                                

Website address                                            

Secondary contact name                              

Secondary contact daytime phone number  

Secondary contact email address                 

Provide an overview of your project and a brief history of the organisation and clearly explain what particular aspect(s) of the project the possible donation will fund. Please send photos where possible to support your project.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the project located within East Sussex County administrative area?

 

 

Postcode:

 

 

 

1. Explain why you believe there is a genuine local need for this project.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Explain the community participation, partnerships and community benefit involved within this project.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.  Demonstrate the sustainability of this project. Please also provide details of funding streams that the project already receives (if relevant).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Would you be requesting the donation as:

 

One total amount       

 

Instalments                 

 

 

 

4.            Explain if the project offers environmental benefit to the communities it serves.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Explain how the project offers education, life-long learning and skills for the communities it serves.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Explain how this project offers value for money for the funder and an itemised breakdown for proposed costs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. Demonstrate how this project offers social inclusion and breadth of engagement across the community.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8. Explain how communities can access this project and get involved.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMOUNT REQUESTED

 

 

                       

PAYEE (IN CASE OF POSITIVE OUTCOME)

 

                       

 

 

Has this project received a donation from the Viridor in East Sussex Fund within the last twelve months?

 

 

 

If yes, please provide details:

 

 

 

 

 

 

 

Email this form to: viridorineastsussex@viridor.co.uk