Application Form by P83R4KN


									                              Please complete this Application Form on your PC and
                              email the completed form to

                              Organisation Details

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

 3. Name by which your
    organisation is
    commonly known

 4. Website

                              Contact Details

 5. Name and title

 6. Position in the

 7. Name and title of Chief

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

                               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
    Please include an
    estimate of the number
    of beneficiaries.

19. Geographical area of

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

    For time-limited            Start date         Finish date


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

    Enlarged sympathies,
    i.e. increased
    understanding and/or
    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

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)

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

                                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)


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


Position in applicant


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