Trust Application Form

Before completing the application form make sure you can answer "Yes" to the following questions:

Have you read and understood the Rules and reviewed the FAQ's of the Trust? Yes
Make sure you have looked through the rules and FAQ's and understand them. This will save a lot of time in completing your form and disappointment if you do not qualify.

Is the application aimed at the grass roots participant? Yes

Is your activity aiming to increase sporting participation at grass roots level? Yes
Particular consideration will be given to applications that involve one or more of the Trusts priority groups (schools, ethnic minorities, boy/girl mixed activities, disability groups, area of urban or rural deprivation)

Applicants budget is already secure and in place? Yes
Ensure you have your budget in place prior to submitting your application form.
Note: Your voucher is valid for 6 months only.

( ^* Required Entry )
Applicants Organisation:
Applicants Budget:
Award applied for:	£100 £200 £300
Previous application number (if any)

Section 1 - About You, the Applicant

Name of your organisation (e.g. Anytown Football Club or name of school etc)

Address of Organisation
Address
County:
Postcode:
^* Email:
Website:

Telephone	Fax
Telephone (day)	Fax (day)
Telephone (eve)	Fax (eve)

Address for correspondence if different from above

Address:
County:
Postcode:

Name of the Head of your organisation
(chair person, chief executive or equivalent)

Title (Mr/Ms/Mrs)
First Name
Surname
Position held in the organisation

Telephone	Fax	Other
Telephone (day)	Fax (day)	Mobile
Telephone (eve)	Fax (eve)	E-mail

Name of the co-ordinator
(person we should communicate with on all matters)

Title (Mr/Ms/Mrs)
First Name
Surname
Position held in the organisation

Telephone	Fax	Other
Telephone (day)	Fax (day)	Mobile
Telephone (eve)	Fax (eve)	E-mail

Address for correspondence if different from main organisation's address

Address:
County:
Postcode:

Section 2 - About Your Activity

Give full details of your sporting requirements. ( eg: Teamwear / Equipment etc )
What are the aims and objectives of your activity? (e.g. recruit new players, encourage sporting activity)
Who will benefit from the award? (e.g. local community, schools, other sports clubs)

Section 3 - Making a Difference

How would an award make a difference to your activity? (e.g. what activities can be undertaken with the award)
Is the activity dependent upon an Award? ( Please explain your answer)
Has your organisation received any other funding for grass roots sports activity - if so please give date, amount and details. (e.g. Awards for All, Football Foundation, Lottery, Foundation for Sport, and the Arts, Single Regeneration Budget etc.)

Section 4 - Participation and Crediting your Award

Please enter HOW MANY will particpate in each age group

0-5

6-10

11-16

Does your activity Significantly or Exclusively involve any priority groups?
(tick boxes that apply)

Boys/Girls	Significantly Exclusively N/A
People with a disability	Significantly Exclusively N/A
Recreationally deprived areas	Significantly Exclusively N/A
Ethnic Minorities	Significantly Exclusively N/A

Please select which of the ethnic origins best reflects the majority of people who will
benefit from the Trust Award.

White: British	Irish	Other White background
Mixed: White & Black Caribbean	White & Black African	White & Asian	Other mixed background
Asian or Asian British: Indian	Pakistani	Bangladeshi	Other Asian background
Black or Black British: Caribbean	African	Other Black background
Other ethnic group: Chinese	Any other

Section 5 - Affiliation

Please provide details of your Club/School recognised association/league

Do you have a Child Protection Policy in place within your organisation? Yes

I / We certify that all information given on this form on our behalf is accurate.

Name	Position	Date
Name	Position	Date

The trust recommends you print/save this email for your records.

Registered Charity No. 1104650