Sse Hunterston/Fairlie Community Fund

FAIRLIE COMMUNITY TRUST

SSE HUNTERSTON/FAIRLIE COMMUNITY FUND

APPLICATION FORM FOR SMALL GRANT OF UP TO £250 BY INDIVIDUALS OR NOT FORMALLY CONSTITUTED GROUPS

Please read the accompanying Guidance Notes before completing each section

Section 1 – Contact Details

1a Name of individual/group

1b Contact name for application

1c Address

1d e mail address

1e Telephone daytime evening/weekend

Section 2 – About you/your group

2a If a group, how many members in the group?

2b If a group, how many members are permanent residents of Fairlie (KA29 postcode)?

Section 3 – Details of grant requested

3a In no more than 25 words describe what you wish the grant for. Please complete on separate sheet clearly marked Q 3a

3b In no more than 50 words explain how the grant will benefit you, your members, and if applicable the wider Fairlie community. Please complete on separate sheet clearly marked Q 3b

3c If you are seeking the grant for a project, event or activity, what is its total estimated cost? Make sure VAT is included as applicable.

3d Are you seeking the grant for a project, event or activity, that requires planning or other statutory consent? If so are all consents in place? Please provide copies of each consent.

1 Issue04/2014.1 3e Are you seeking the grant for a project that will take place on land or property not owned, rented or otherwise controlled by you or a member of your group? If so do you have the consent of the owner? Please provide a copy of the consent.

3f If you are seeking the grant for an event or activity, is the event a 'one off' event or an annual event which has taken place in the past year?

3g What is the total estimated cost of the project?

3h What contribution do you wish from the SSE Hunterston Community Benefit Fund?

3i If there is a shortfall how do you intend to make this up?

3j If you receive the amount requested, are you in a position to start the project/hold the event within three months, and thereafter see it to completion within 12 months?

3k When is the expected date of completion of the project or date of the event?

Section 4 – Further Information

4a If there is any further information you would like to provide in support of your application please submit on separate sheet BUT do not repeat information already given.

Section 5 – Have you included the following with the completed application form? a) If applicable a copy of all statutory consents and/or landowner agreements b) If applicable a copy of any estimate(s) or supplier quotation(s) relating to the project. c) Your response to Q 3a and Q3b and any additional information sheets.

d) If relevant to the project, a copy of the organisation's Child Protection/Vulnerable Adult Policy

Declaration

By submitting this application to Fairlie Community Trust I certify that the information given is correct. I understand that the decision made by Fairlie Community Trust/SSE with regard to the application is final.

Signed and dated

Please return completed form to

The Administrator SSE Hunterston/Fairlie Community Fund

2 Issue04/2014.1 30 Bay Street Fairlie KA29 0AL

3 Issue04/2014.1