Application Form Groups/Projects

Please use this application form for groups/projects – if applying as an individual you should complete the Individual Application Form instead.

Title(required)

First Name (required)

Surname (required)

Address and postcode(required)

Telephone number (mobile or evening tel number) (required)

Email address (required)

Name of Group (required)

What size of bursary are you applying for (please give an approximate figure if exact costs are not known)(required)

Have you applied to the Brereton Fund Previously? (required) Yes

If you have previously applied, please state the year, amount requested and whether successful or not.

What will this money be used for? – give as much detail as you can.(required)

Who will benefit from this bursary?(required)

Are you applying for funding from any other sources? Please give details.(required)

Any other information you about your group/society which you think is relevant to your application.

Group status Registered charity

I have emailed a copy of our latest accounts/statement of income and expenditure to info@breretonfund.org

Any other details

Please note that the Fund cannot fund on going running costs for longer term projects. Please describe how you envisage the project will continue beyond the support of the Fund e.g. how on going costs will be supported.

I am happy for the Brereton Memorial Fund to contact me by email. (required) Yes

I am happy for the Brereton Memorial Fund to contact me by post. (required) Yes