Starter Grant Application Form

Eligibility Criteria(Required)

To ensure applicants for the Hull CVS Starter Grants meets the funders eligibility criteria, please can you confirm the following

My group / organisation is based in Hull

My group / organisation has an annual income less than £2,000

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Section Break

Unique ID

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Application Status

Please tell us your name(Required)

First Last

What is your role / position in the organisation?(Required)

Telephone(Required)

Email Address(Required)

What is the name of the organisation or group?(Required)

What is your organisations legal status?(Required)

A voluntary organisation

A community group

A registered charity

Constituted Group

CIC (Community Interest Company)

Company (Ltd by guarantee)

CIO (Charitable Incorporated Organisation)

Other

What causes does your organisation support?

Addiction

Animal Welfare

Arts, Culture & Heritage

Community

Disability Services

Disaster & Emergency Response

Education & Training

Environment

Equality

Family Support

Food Insecurity

Health

Homeless

Human Rights

Indigenous Peoples

International Aid

Justice

Mentoring & Advocacy

Migrant Support

Offender & Ex-Offenders Support

Older People

Recreation

Returned Service People

Sport

Young People

Other

What is your organisations address?(Required)

Street Address Address Line 2 City ZIP / Postal Code

Please tell us briefly about the work of your group(Required)

In the case of a very new group that is not set up yet, please tell us what the group will do.

When was the group set up?(Required)

Day

Month

Year

Roughly, how many people will your group help in a year?(Required)

Does your group have a governing document?(Required)

For example a Constitution, or set of rules, a Memorandum and Articles of Association, etc.

Yes

Please can you attach your governing document using the button below(Required)

Max. file size: 512 MB.

Does your group have a bank account in the name of the group?(Required)

If your group does not have a bank account in the name of the group and your application is successful, we will contact you to discuss the grant payment

Yes

What bank is your organisation account with?(Required)

Please enter the bank account name to which cheques should be made payable to(Required)

This should be the same as your group’s name. If it is not, please explain the reasons why

Please upload a copy of your most recent bank statement(Required)

This should be the same as your group’s name. If it is not, please explain the reasons why

Max. file size: 512 MB.

Please tell us how you will use a Starter Grant(Required)

How much money are you applying for? (max £200)(Required)

Please enter a number from 1 to 200.

What will this be used for? Please add a single item name or short description and costings per line. If the item is a product, please include a weblink to the product page. To add more items, please press the plus button.

What will this be used for?

Please add a single item name or short description and costings per line. If the item is a product, please include a weblink to the product page. To add more items, please press the plus button.

Item Description

Link to Item

Cost

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Summary

How many people will benefit from this grant?(Required)

How much money has your group already received from any source in the last 12 months?(Required)

Please include all grants, payments, fundraising and donations

Has your group received a grant from any of the following in the last 12 months?

Tick all that apply

The Sir James Reckitt Charity

Hull CVS Starter Grants

Please can you tell us how much you have received?(Required)

When did you receive this funding?(Required)

Day

Month

Year

Have you previously been applied and successful for a Starter Grant?(Required)

Yes

Please give the contact details of someone who knows you, and has agreed to vouch for your group and the things that you are trying to do.

This should be someone who holds a position of responsibility in the community such as a local Development Worker, Neighbourhood Coordinator, councillor/professional or similar.

Referee Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City ZIP / Postal Code

Telephone(Required)

Email Address(Required)

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Panel Date

DD slash MM slash YYYY

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If unsuccessful or referred, what was the reason for this outcome?

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Payment Request Date

DD slash MM slash YYYY

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Requested By

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Purchase on behalf of Organisation (No Bank Account)

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Bank Account Number

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Sort Code

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Committed

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Awarded

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Payment / Purchase Made

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Payment / Purchase Date

DD slash MM slash YYYY

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Notes

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Notify Finance(Required)