Grant Application

HDH 1965 Charitable Trust

Official Use Only  

Date recieved:

Category:

Ref No:

The Charity
Name of charity:
If the charity is part of a larger organisation please enter its name below
Parent Organisation:
Charity Registration Number:
Charitable Status:
Brief description and the main aims and activities of your organisation? (including geographical area of support)
Contact Details
Address:
Address 2:
City/Town:
County:
Post Code:
Contact Name:
Position Held:
Contact Phone Number:
Email Address:
Website Address:
The Project
Total Funding requested:
Overall project cost:(If applicable)
Funding Raised to Date
Project Summary: (You can go into more detail here or upload a project proposal. )
Previous Applications:
Please list any previous applications to the HDH Wills Charitable Trust within the last 5 years, and whether they were successful or not.
Last audited/examined Statement of Financial Activities
Year Ending
Income
Expenditure
Unrestricted Reserves
Grant Payment
Should your application be successful, payment will be made by cheque. Please enter the name of the organisation to which the cheque should be made payable to:
Payee
Please sign and date the following declaration:
Declaration
To the best of my knowledge, all the information that I have provided in this application form is correct. I confirm our organisation is happy for our organisation’s details to be included on The HDH Wills 1965 Charitable Trust website:
Signature: Date:
Print name:
Checklist:
Copy latest accounts attached
Project document attached or typed into space provided above
Payment details completed
Please send this form together with an application letter/project proposal and your most recent accounts (on your organisations headed paper if possible). To:

Sue Trafford,
The HDH Wills 1965 Charitable Trust,
Henley Knapp Barn,
Fulwell, Chipping Norton,
Oxfordshire,
OX7 4EN