Grant Application Form

Please complete this form, either by typing in the boxes (which will expand) or by hand.  Please do not expand the form beyond 3 sides.

Then send it, along with a short letter telling us more about your project (don’t duplicate information you have given us in the form) to JRL Smith Correspondent, The Roughley Trust, 90 Somerset Road, Edgbaston, Birmingham B15 2PP.

Please always use a different font when you complete the form
Also include your latest annual accounts (unless they are already on the Charity Commission website)

Charity name, address and postcode:

Charity website address: 		

Charity Registration Number:		When was the charity founded?		

Are you a national, a national with separate local projects with their own accounts, or a local charity?

Why are you asking for a grant? Is it to fund existing work, develop existing work, or fund a new project?

Address and postcode of project, if different from above:

What does the project for which you are applying seek to do?

What group of people will your project help? Tell us about your clients.

Roughly how many people benefit from your work in an average week?		

How is the charity managed? Give brief details of the qualifications and expertise of one or two of the key people involved.

Staff: how many people are involved in the Charity's work?
Full time staff:		Part time staff:		Volunteers:		

Have you recently approached The Roughley Trust?  Please give details including the date and amount of your most recent grant.

How much do you hope to raise from Charitable Trusts this year - and where do you expect the funding to come from?

Your charity accounts

What is the end date for your latest audited accounts?		

Take this information from your latest accounts (your Total Income should match the Total Income in your Annual Accounts). Add in detail if you wish.

Income Analysis (from all sources)
Earned Income		
Investment Income		
Local Authority Grants		
Grants from Primary Care Trusts or similar NGOs		
National Government Grants		
Other grants		
Big Lottery		
Grants from Charitable Trusts		
		
Other Fundraising		
Total Income for the year 
(as shown in your Accounts)		
		
Expenditure		
Staff Expenditure		
Other Charitable Expenditure		
Total Expenditure for the year 
(as shown in your Accounts)		
		
Surplus or Deficit (say which)		
This year		
Last year		

Is there anything else we need to know to understand your financial position better?

Your contact details

Telephone number:		Email address:		

Address for correspondence, if different from above:

Signed:	Please print name:	

Date:

Please remember to send a short letter telling us why your project should be supported, and enclose your latest accounts if they are not showing on the Charity Commission website www.charity-commission.gov.uk 

You may also send other supporting material if you wish, but Trustees  may only see your letter and the application form.  A short and succinct letter will help your project to be shortlisted.