Coventry Building Society's Charitable Foundation Application Form

Please complete this application form carefully. Make sure that you provide concise and comprehensive information to help us assess your application. You can fill the form in online and print using the print button at the bottom of the page or you can print the blank form in the same way and fill it out later.

About your organisation

Name of your charity

Contact name

Daytime telephone number

Evening telephone number

Address

Postcode

Are you a registered charity?

Registered No.

Date founded

Please give a brief summary (on a separate sheet) of your organisations short and long term aims, main areas of work or services, number of people benefiting and geographical area in which you operate. (Attach a separate sheet if necessary)

How many people does your organisation employ?

How many volunteers?

About your project

Please give details (on a separate sheet) of the project including the project aims and timescales.

How many people will benefit as a direct result of a grant form the Foundation?

Please give details (on a separate sheet) of how you have raised or how you intend to raise any additional funds?

What is the total cost fo the project?

How much would you like us to contribute?

Other information

Please provide a copy of your organisation's latest report signed and approved by your management board/committee.

Please provide any further information (including current literature) which you feel may be helpful to the Trustees of the Coventry Building Society Charitable Foundation.

Declaration

I confirm that I am authorised to sign this application on behalf of the applicant organisation. I also confirm that the information given is correct and that, if this application is successful, the organisation will be bound to use the grant exclusively for the purposes specified in the application.

Signature ............................................................................... Date: ........................

Position: .................................................................................................................

Note: Please return all paperwork to the Trustees, Coventry Building Society Charitable Foundation, PO Box 600, Oakfield House, Binley Business Park, Coventry, CV3 2YR.

Back

Coventry Building Society is authorised and regulated by the Financial Services Authority (FSA reference no: 150892 www.fsa.gov.uk). The Society is a member of the Building Societies Association. This site is intended for UK residents only. Coventry Building Society. Registered Office: Economic House, PO Box 9, High Street, Coventry CV1 5QN.

Our telephone advisors are available Monday to Friday 8am-8pm, Saturday 9am-5pm, Sunday 10am-4pm. Contact your service provider for details of charges, as call costs may vary. To maintain a quality service, calls made to and from the Society may be monitored and recorded.