SNOWBALL TRUST - GRANT APPLICATION FORM �A� by lv6sU7W

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									SNOWBALL TRUST - GRANT APPLICATION FORM ‘A’

Snowball is a registered Charity whose aims include the provision, in full or in part, of resources
for sick, handicapped or disabled young people in Coventry and Warwickshire whilst under the
age of 21 years and where the family of such persons are unable to provide the resource
identified and independently validated.

The trustees of Snowball would welcome your personal letter in support but reserve the right to
exercise discretion in the grant or refusal of any request without liability to explain their action
in so doing.

      1.     Name of intended recipient:.........................................................................................................................

      2.     Address:.......................................................................................................................................................

             ......................................................................................................................................................................

      3.     Date of Birth:...................................................................................

      4.     School/College attended:.............................................................................................................................

      5.     Nature of handicap/illness or disability:......................................................................................................



      6.     Amount requested (please enclose supplier’s estimate, noting that all grants are made EXCLUSIVE
             VAT) - £

      7.     What equipment or facility will the sum provide:.......................................................................................

      8.     Where will it be provided: eg home, school, etc.........................................................................................

      9.     Anticipated benefit to recipient: ie mobility, assist education, etc.............................................................

      10. Brief indication of applicant’s or family circumstance that validate Charity provision:.............................



      11. Attached evidence of need from school/ health resource, etc......................................................................

      12. Is a local authority involved in the care of this child, and if so in what way:..............................................


      13. Have you applied to any other Charity? If so and a grant is made please let us know:.............................


      14. Details of any previous successful Snowball application:...........................................................................

      15. Please give details of the organisation to whom cheques should be payable, taking account that it MUST BE an
          official body or an equipment supplier:




Signed:............................................................................


Relationship to child (ie Parent, Guardian or position in group):.......................................................................


Date:.................................................................................

								
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