Dora Beeforth Memorial Fund This is a means tested grants programme. Grants to support young people from Applicants’ total household income must low income families to participate in be less than £490 per week (excluding sport, outdoor education and foreign all benefits). travel If you are interested in applying to Funded this Fund, please read the following The Fund was established in memory of details carefully: Dora Beeforth, the wife of the Foundation’s first Director. Dora was born The Fund will not normally pay for in Cumbria and attended the Lakes School family holidays in Windermere. She enjoyed the outdoors, trips in the UK under three days’ was a volunteer warden with the Lake duration District National Park and a volunteer with computers Cumbria Youth Theatre. She was also a activities which involve the promotion keen runner and orienteer. The Fund was of religious doctrine created in her memory to enable children vehicle purchase costs and young people to experience activities and opportunities which they otherwise How much can you apply for? would not be able to afford. maximum grant will normally be £500 over one year The Fund received a £10,000 boost in individuals will normally only qualify 2012 as a result of the tragic death of for one award from the Fund Michael ‘Mic’ Machell. Mic died at the age if you wish to apply for a larger of 23 in a climbing accident in the USA. amount please talk to Foundation staff Members of his family and friends donated before applying money to the Langdale and Ambleside Mountain Rescue Team to provide a We also administer a number of small funds lasting memorial to Mic. Mic was an active using similar criteria which cover specific member of the team for three years, areas or ages. We will automatically consider being involved in 170 rescues. The appropriate applications. Mountain Rescue team decided they wanted the money to be used to support If you would like to apply to this Fund young people developing a career or please contact: gaining experience in the outdoors, something which is possible through the Ellen Clements Dora Beeforth Memorial Fund at the Community Foundation. Dora and Mic Tel 01900 825760 shared a love of the hills and although Fax 01900 826527 they never met, they had the same Email [email protected] personal motto ‘Carpe Diem’. Web www.cumbriafoundation.org
Who can apply? Young people between 11 and 21 and organisations working with young people. Applications from individuals should set out how and why a trip will benefit them.
Cumbria Community Foundation, Dovenby Hall, Dovenby, Cockermouth CA13 0PN Charitable company limited by guarantee Registered charity no 1075120 18.08.2010
PLEASE RETURN THIS FORM by post to Cumbria Community Foundation, Dovenby Hall, Dovenby, Cockermouth CA13 0PN.
If you are unsure about the meaning please contact a Grants Officer on 01900 825760 Please complete the form as fully and clearly as possible.
Mr/Mrs/Miss/Ms/other Full Name
Date of birth Place of birth
Home address Term time address (if applicable)
Telephone Telephone Email Mobile Years lived in Cumbria
Details of Secondary/Further Education Dates School/College/University attended Qualifications gained
Details of applicant income (gross before tax) for the last two years Dates Occupation/Source of funding Annual income £ £ Please include support funding for example grants as well as earned income. Cumbria Community Foundation Applicants under 18 and for higher/further education
Details of parent(s) or guardian(s) Names
Home address (es)
Postcode Email Telephone Ages of other dependent children in household (if any)
If parents are separated or divorced, please indicate which one you live with and the amount the other parent provides as financial support on an annual basis.
Details of household income (gross before tax) Father/Guardian Mother/Guardian Source Weekly income Weekly income Earned income £ £ Unearned e.g. rental income £ £ Benefits and allowances £ £ Maintenance £ £ £ £ £ £ Total £ £ If parent(s) is/are unemployed, retired or unable to work, please provide weekly amount of Income Support or benefits, pension, or special allowances etc. Savings £ £
NB Please provide evidence of household income: at least two recent payslips and confirmation of benefits receivable.
Other funding Please provide information about other funding eg personal contribution and/or fundraising. Please include details of applications made to the local authority or other body for grant aid or a student loan. If you have been awarded a grant/loan, please provide a copy of the notification of amount awarded. Funder £
Page 1 Cumbria Community Foundation Applicants under 18 and for higher/further education
Activity details Proposed activity/course of study College/University/Training provider Course/Activity title Details (length of study, full/part time, location, start and end dates)
Course year eg 1st , 2nd, 3rd year If you have received an offer or acceptance letter from the College/University/Provider, please enclose a copy of this document.
What do you want the grant to pay for?
Breakdown of proposed expenditure Cost £
Total amount requested
When do you expect the money to be spent by?
Please give details of any special circumstances or specific difficulties, which you feel should be taken into consideration when the Committee consider your application. This includes details of personal circumstances, for example special needs, and also how the grant will benefit the wider community.
Page 2 Cumbria Community Foundation Applicants under 18 and for higher/further education
Please give the name, position and contact details for a referee. This must be your education/training adviser. Name Position Address
Telephone Email Checklist Have you completed all sections of the form? Have you enclosed copies of the following documents: Offer or acceptance letter from College/University/training provider? Notification of other funding? Additional information Curriculum vitae (useful but not essential) Payslips and benefit information Conditions and signature If offered grant aid, you must agree to the following conditions: you must claim the grant within three weeks of written offer. Unclaimed grants will then be withdrawn. Any other arrangement must be agreed in writing with your grants officer. the grant will be used for the purpose for which it was approved. you must provide details of how the grant was spent and how it has helped you. Reports and photographs may be used for publicity. records will be kept of expenditure for at least five years and will be supplied to the Foundation if requested. any proposed material change to the details of the application will be notified to us. the grant is a donation and the Foundation is not liable for the consequences of its use.
Please sign and date below to confirm that the information provided is true and accurate
Applicant’s signature Date
Guardian’s signature Date (Guardian’s signature required for applicants under age 18) Should you be awarded a grant, please provide details of the cheque payee.
Payee Applications may be submitted by email. A paper copy of the form with original signatures in ink must also be submitted. No award will be paid unless a signed form is provided. Cumbria Community Foundation may request evidence to confirm information given on this form. The Foundation reserves the right to reclaim any money which has been paid as the result of fraudulent or misleading claims
Data protection: Cumbria Community Foundation will process information on this form. We will hold the information on computer. We may provide copies of the details to partner organisations including government bodies (eg Department for Work and Pensions or local council). Please tick here if you do not want us to share information with other organisations.
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