Application Form by P83R4KN

VIEWS: 0 PAGES: 6

									                              Please complete this Application Form on your PC and
                              email the completed form to ngordon@raynetrust.org

                              Organisation Details

 1. Name of organisation
 2. Legal Status
    company limited by
    guarantee
    friendly society
    registered charity                 Charity number:
    voluntary organisation
    other                              If other please
                                       specify:

 3. Name by which your
    organisation is
    commonly known

 4. Website

                              Contact Details

 5. Name and title



 6. Position in the
    organisation

 7. Name and title of Chief
    Executive/Director

 8. Address Line 1
 9. Address Line 2
10. Address Line 3
11. Town
12. Postcode
13. Email address
14. Telephone




                                        -1-
                               Areas of Special Interest

15. Which area of special             Improved relations between Jews and Arabs
    interest is your                  in Israel
    organisation working in?          Improved mental health among
                                      disadvantaged people


                               Organisation Activities

16.   Describe briefly what
      your organisation does
      (100 words maximum)




                               Project Details

17. Name of project

18. Briefly describe your
    project and why it is
    needed (250 words
    maximum).
    Please include an
    estimate of the number
    of beneficiaries.




                                       -2-
19. Geographical area of
    Benefit

20. Is your request for:
    an ongoing project
    a time-limited project

    For time-limited            Start date         Finish date
    projects:


                                  Outcomes

21. Which of The Rayne
    Trust’s ‘bridge building’
    outcomes will your
    organisation or
    programme achieve?
    Please tick the relevant
    answer(s)

    Enlarged sympathies,
    i.e. increased
    understanding and/or
    tolerance
    Reduced exclusion
    Reduced conflict
    Productive relationships
    which benefit the public

     Other - please specify:


22. Please list up to four
    outcomes that your own
    organisation aims to
    achieve through your
    programme




                                             -3-
                                  Aims
23. Please demonstrate how
    your work fulfils the aims
    of the Rayne Trust.

    It is innovative because
    (50 words maximum)




    It provides direct benefits
    to people and
    communities because (50
    words maximum)




    It brings in additional
    funding and encourages
    the involvement of other
    organizations because
    (50 words maximum)




                                  Project Budget

24. Total cost (in £GBP)




                                         -4-
25. Sum requested from
    Rayne Grants (in £GBP)



26. How much your
    organisation is
    contributing to the
    project (if applicable)
27. Free reserves (as a
    percentage of annual
    expenditure)




                                Further Information

28. If there is anything else
    about your work which
    you feel it is important
    for us to know and is not
    covered above, please
    explain this here
    (particularly if there is
    something unique or very
    special).(100 words max)




                                       -5-
                              Declaration

In submitting/signing this
completed application, I
confirm that to the best
of my knowledge and
belief all the information
in this application is true
and correct. I declare
that I am authorised to
make this application.

Submitted by

Date

Position in applicant
organisation




                                     -6-

								
To top