Grant Application

1Organisation

2Project

3Objectives

4Financial

Step 1 — Details of your Organisation

Organisation Name *

Address

Street *

City *

County *

Postcode *

Country *

Email Address *

Phone Number *

Name of Contact *

Name of Chair of Organisation *

Aims and Purposes of your Organisation *

How is your organisation constituted? (Company, trust etc.) *

How is it funded? *

Staff & Volunteers

Number of Full-time staff

Number of Part-time staff

Number of Volunteers

Number of Committee / Board members

Step 2 — Details of your Project / Financing

Name of Proposed Project *

Image of Project (JPG, PNG or PDF — max 10 MB)

Proposed Date of Commencement *

Duration of Project *

Description of Project *

Total Cost of Project *

Amount Requested from The Primrose Trust *

Is your organisation VAT registered? *

Yes No

Financing the Balance

For each funding source, enter the amount already secured and the amount still pending.

Source	Name / Details	Amount Secured	Amount Pending
Own Resources	—
Trusts
Statutory Authorities
Other Sources

Step 3 — Objectives

Objectives of the Project *

How will you evaluate success? *

Who will benefit from the project? *

Any other relevant information

Sustainability - Will the project require revenue funding following completion? If so, quantify annual amount and provide a breakdown and specify how that amount will be financed. *

Step 4 — Financial History

Please provide figures for your three most recent financial years, most recent first.

Item	Year 1 (Most Recent)	Year 2	Year 3
Year End Date
Total Revenue Income
Total Revenue Expenditure
Total Income Specifically for Capital Purposes
Total Capital Expenditure
Net Assets at End of Year
Investments at Year End

Please tick to confirm that the information you have supplied has been checked and is correct. *