<p> Application Form for SwansAid Funding Autumn 2017-2018 Season</p><p>Box A Select this box if you wish to apply for an award of up to £10,000</p><p>Box B Select this box if you wish to apply for an award of up to £5,000</p><p>Box C Select this box if you wish to apply for an award of up to £2,000 </p><p>IMPORTANT: Read the guidance notes before completing this form.</p><p>Section 1: Contact details</p><p>Name of organisation</p><p>Charity reg. number (if you have one) Or Affiliation number Address of your organisation/ team/school/etc</p><p>Name of main contact</p><p>Email address of main contact Telephone number</p><p>Section 2: Bank Details</p><p>Name of bank</p><p>Address of Bank</p><p>Account name</p><p>Sort code</p><p>Account number</p><p>SwansAid is administered by Swansea City AFC Community Trust Charity number: 1126933 Section 3: About your organisation (Please read the guidance notes carefully before answering this question)</p><p>Please describe your organisation. </p><p>Answer:</p><p>Section 4: About your project (Please read the guidance notes carefully before answering these questions) a) What? Please describe the project which you would like SwansAid to support.</p><p>Answer:</p><p> b) Who? Please tell us who will carry out the project and who will benefit from the project.</p><p>Answer:</p><p> c) Where? Please tell us where you will carry out the project.</p><p>Answer:</p><p>SwansAid is administered by Swansea City AFC Community Trust Charity number: 1126933 d) When? When do you want to start your project and when do you expect the project to end?</p><p>Answer:</p><p>Section 5: Measuring our impact </p><p>Part a) If you are applying on behalf of a community sports club</p><p>Now Project completion</p><p>Participants/members</p><p>Teams</p><p>Coaches level 1</p><p>Coaches level2 </p><p>Coaches level 3 and above</p><p>Training sessions/ opportunities per week</p><p>Part b) If you are not applying on behalf of a community sports club</p><p>Answer:</p><p>SwansAid is administered by Swansea City AFC Community Trust Charity number: 1126933 Section 6: The budget</p><p>Use this section to tell us how much money you are requesting and how you will use it. You may add extra rows below if necessary.</p><p>Item cost e.g. 2 x Mobo cruiser recumbent cycles at £295 each £590</p><p>Total requested from SwansAid</p><p>Section 7: Publicity</p><p>Are there any matters we need to be aware of in advertising our support of your organisation?</p><p>SwansAid is administered by Swansea City AFC Community Trust Charity number: 1126933 SwansAid is administered by Swansea City AFC Community Trust Charity number: 1126933 Section 8: Signatures</p><p>In signing this you confirm that you are authorised to make this application for funding on behalf of your charity or community group, that you have read and understood the guidance notes, and that you are happy for us to store and use the information within for the purpose of assessing the application and for future reference.</p><p>Name</p><p>Signature </p><p>Role</p><p>Date</p><p>Name</p><p>Signature </p><p>Role</p><p>Date</p><p>SwansAid is administered by Swansea City AFC Community Trust Charity number: 1126933 Checklist:</p><p>Governing documents ☐</p><p>Bank statement ☐</p><p>Accounts ☐</p><p>Quotes for purchases ☐</p><p>Spread sheet ☐</p><p>Child protection policy ☐</p><p>Vulnerable person policy ☐</p><p>Other documents* ☐</p><p>*Please specify here</p><p>Any personal / confidential information contained within this document is handled in accordance with the ‘Data Protection Act 1998’ and ‘The General Data Protection Regulation 2016’. If you would like any further information or to request access to the data we hold, please email [email protected]</p><p>SwansAid is administered by Swansea City AFC Community Trust Charity number: 1126933</p>