Grant Application for Clubs/Teams/Organisations

This form should be used by any clubs, teams, or similar organisations within Surrey Heath who wish to apply for a small grant (max £250) which would benefit the development of sport in the borough. Applications should be for new initiatives that encourage new participants (grants will not be awarded for existing schemes or maintenance). Examples of this may include the purchase of equipment, not-for-profit event costs etc.

Name of Club / Organisation *

Name of lead applicant *

Address of lead applicant

Country *

Address 1 *

Address 2

Town/City *

Postcode *

Telephone Number *

Email Address *

Position held within the organisation (if applicable) *

Provide a briefoverview of your organisation and who it caters for *

Please include whether you work with people from traditionally underrepresented groups in sport - examples could include people with disabilities or Special Educational Needs (SEN); Black, Asian and Minority Ethnic groups; members of the LGBT community, older people etc.

Level of grant your organisation is applying for (max £250) *

Please give details of the project/activity the grant will be used for *

How would this grant contribute to the Sports Council’s aim of increasing sports participation in Surrey Heath? *

Please provide a break-down of financial costings of the project/activity this grant would be used for:
Item Required	Number of items	Cost of item
Item Required	Number of items	Cost of item
Item Required	Number of items	Cost of item
Item Required	Number of items	Cost of item
Item Required	Number of items	Cost of item
Item Required	Number of items	Cost of item
Item Required	Number of items	Cost of item
Item Required	Number of items	Cost of item

Total *

If the total cost is greater than the grant being applied for, please state from which other sources it is being contributed from

Declaration

Please note that the information provided in your application will be processed by Surrey Heath Borough Council officers and made available to the Committee of Surrey Heath Sports Council.

I declare that the information given above is, to the best of my knowledge, correct and I understand that any misleading statements or false information given during the application process may render the application invalid and any grant paid will be returned to Surrey Heath Sports Council.

I give permission for Surrey Heath Sports Council to publicise my grant should I receive one, and the following information may be put on the Surrey Heath Borough Council website: club, sport, club details and reason for grant (please delete any information you do not want to appear) . I understand that I may submit a photograph to be added.

I accept that by applying for a grant the organisation may be nominated for the Surrey Heath Sports Awards. I understand that submitting an application does not guarantee a grant award, and that all grants are made at the discretion of Surrey Heath Sports Council.

The information provided will only be used for the reasons outlined above. I understand that if I have any concerns in regards to the above, I should contact a member of the Surrey Heath Sports Council before signing.

Please tick to indicate that you agree with the declaration above: *

I Agree