Ynysybwl & Coed-y-Cwm Council Grant Application Form (S137 of the LGA 1972)

1. Name of Organisation ………………………………......

2. Address ………………………………......

………………………………...... Telephone No: …………………………. 3. You should attach with this application a copy of your organisation’s most recently audited statement of accounts. If you do not have one (e.g. a newly-formed organisation) please state why and the approximate finances which the organisation has or can expect from other sources.

………………………………......

………………………………...... 4. Please indicate what costs you are likely to face in the financial year, or the immediate future, (if there are any documents, bills, etc. which you can provide, please enclose these in support of the application).

………………………………...... 5. State briefly the purpose for which you are seeking financial assistance e.g. general assistance; or specific project. (if the latter, please provide what information you have on costs and any supporting documents, price lists etc.)

………………………………...... 6. Please assess the benefit which any donation would have to the Community, e.g. Is your service used the local residents? And how many? If the organisation is not based in Ynysybwl or Coed-y-Cwm, does it have members from those communities etc.

………………………………...... ………………………………...... (Please attach any more information you wish to use in support of this application)

7. Name of the Organisation to which cheque should be made payable in the event of the application being successful. (If different from 1). ………………………………...... 8. Name and address (if different from 1 & 2) of the Person being the applicant on behalf of the organisation.

………………………………......

………………………………......

9. Signed:……………………………...... Date: ………………………………......

Note: It is a condition that where a grant of £2000 or more has been made by the Council that the organisation must provide a written report to the Council on how the money has been used, within twelve months of the date of the grant.

Please return form to: The Clerk, Ynysybwl & Coed-y-Cwm Community Council The Old Police Station, Paget Street, YNYSYBWL, , Cynon Taf, CF37 3LF