Application for Funding

Please read our funding guidelines carefully before completing this form. There are also guidance notes available to help you. Both documents are available on our website www.trustforlondon.org.uk

Shortlisting Criteria
In addition to answering the questions on the form, please ensure that you provide evidence in your answers which demonstrates how your proposed work addresses one or more of the following: . !. $. &. (. +. ,. -. The potential to have significant influence including an impact on policy. "evelops new and#or imaginative ways of tackling an issue. %inds it difficult to get support because the issue is perceived as being challenging or risky. 'hares best practice and learning with others and the organisation has a clear strategy for this. Targets people and geographical areas most severely affected by poverty and discrimination ) this may include pockets of poverty within relatively well*off areas. 'trong user involvement at all levels. Is accessible and targets those who are the hardest to reach. 'kills, e.perience and ability within the organisation to undertake the proposed work and the work is of a high quality /this may include holding relevant quality marks0.

1ou do not need to meet all the above but we will shortlist organisations which meet a number of them.

Please keep to the word limit as indicated

About your organisation

1. /a0 /b0 /c0 /d0 /e0 /f0 Organisation details 2ame of organisation applying: 3ny other name known as (e.g. previous and/or shortened): 4egal status of organisation: /E.g. Registered Charity/Company Limited by Guarantee0 5harity registration number /if applicable0: 5ompany registration number /if applicable0: 1ear organisation established:

/g0 If this is a 6oint application, please list other organisations, which are part of the formal partnership: 2. . /a0 Summarise the main aims or mission of your organisation / a! "## $ords0 !our organisation"s main acti#ities "escribe your main activities#pro6ects indicating how many people benefit from each of these / a! %## $ords0 Tell us what difference these activities have made /your outcomes07 / a! "## $ords0 8here do your current activities take place7
&lease indicate $hich borough(s) or if London'$ide or (ational.

/b0 /c0

/d0 If you have any relevant quality marks#accreditation provide details of these including at what level (e.g. )ffice of *mmigration +ervices Commissioner ()*+C) level ,): $. %umber of staff and #olunteers in your organisation %ull*time staff: Part*time staff: 9olunteers: &. /a0 'o#ernance :ow many Trustees or ;anagement 5ommittee members do you have7

/b0

8hat specific skills and e.perience do they bring to the organisation7 / a! ,## $ords0 )i#ersity <ive us e.amples of how you promote diversity within your organisation7 / a! -## $ords0 !our organisation"s recent achie#ements 'ummarise your most recent achievements: /please list up to three ' ma! ,"# $ords0 !our organisation"s last financial year Please complete the following table from your most recent audited or independently e.amined accounts. ;ost =ecent 1ear > Prior 1ear >

(.

*.

+. /a0

%inancial year ended ) "ate /dd#mm#yyyy0: Total incoming resources Total resources e.pended 'urplus#deficit Total funds brought forward %unds carried forward =estricted funds ?nrestricted funds "esignated funds Total funds 2et current asset or liabilities /b0 ,.

3re there any financial issues you need to highlight7 / a! "## $ords0 !our organisation"s current financial year

5urrent financial year ends on /dd#mm#yyyy0 3nticipated e.penditure > 'ecured income > &lease list your main current funders and amount secured %under#'ource 3mount /for current year0 >

About your re-uest for funding

8hen completing this section, you will need to provide brief evidence of how your

proposed work meets some or all of the eight points listed at the front of this form. 1.. Summary of re-uest for funding /a0 ?nder which priority area are you applying7
(e.g Employment. /dvice. +ocial 0ustice. 1iolence. +mall Groups: +pea2ing out 3 campaigning activities. +mall Groups: /dvice 3 information $or2 or +mall Groups: *mproving local neighbourhoods. or E!ceptional (please call before ma2ing an application under our E!ceptional category).

/b0 Please summarise your request for funding / a! %# $ords0

11. /e-uest for funding /a0 "escribe the activities you will undertake /include numbers of beneficiaries where appropriate0 / a! 4## $ords)

/b0 8ho will be your main beneficiaries7 / a! %# $ords0

/c0

8hy is the work needed7 / a! -%# $ords0

/d0

8hat difference do you hope to make7 /please list your - (or more) main outcomes0 . !. $.

/e0 :ow will you know you have made this difference7 / a! "%# $ords0

/f0

8ho else is undertaking similar activities and how will your work complement this7 / a! ,%# $ords0 8here do your current activities take place7 &lease indicate $hich borough(s) or London'$ide or
(ational.

/g0

/h0 Is this a new pro6ect7 /1#20: If no, who is currently funding this work7 / a! ,%# $ords0

&

12. Pro0ect costs /a0 8hat is the total cost of the proposed work7 1ear > Total /b0 8hat income has already been raised7 1ear > Total /c0 :ow much are you requesting from Trust for 4ondon7 1ear > 1ear ! > Total 1ear $ > 1ear ! > 1ear $ > 1ear ! > 1ear $ >

Item

%under#'ource

/d0

8hich other funders are currently considering your proposal7

%under#'ource

'tatus

1ear >

1ear ! >

1ear $ >

1 . Pre#ious Funding /a0 :ave you received previous funding from Trust for 4ondon /or 5ity Parochial %oundation07 (&lease indicate 5es. (o or 6on7t 8no$) /b0 If yes, please summarise the main achievements#outcomes from your last grant from us / a! "## $ords)

Finally /

a! ,%# $ords0 Is there any other relevant information you would like to tell us7

Administrati#e information
5ontact person Position in organisation 3ddress

Postcode Telephone 2umber ;obile 2umber 5ontact person email <eneral email 8ebsite Checklist :ave you completed all sections of the form7 :ave you enclosed your latest accounts7 :ave you enclosed your constitution#governing document7 :ave you enclosed the 6ob description /if you are applying for funding for a post07 Please indicate which closing date you are applying to & %ebruary, !- ;ay, or - @ctober /please indicate one only0:

)ate submitted /dd/mm/yyyy0:

Please print your completed form and return with your additional documents by &pm on the closing date to1 Trust for 4ondon + ;iddle 'treet 4ondon A5 3 ,P: Please note we do not accept application forms by email or by fa2. If you have problems completing this application form please contact us at infoBtrustforlondon.org.uk or call C!C ,+C+ + (+ Trust for 4ondon =egistered charity number !C(+!D