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CONFIDENTIAL
GRANT APPLICATION FORM
*
Indicates required field
Application by (teacher/other)
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First
Last
Application by (school/other)
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On behalf of
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Sum requested (£)
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Full cost of the activity (£)
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Date of the activity
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If a grant is awarded payment will be by bank transfer where possible. Please provide the appropriate bank account details below.
Sort code
*
Account number
*
Your reference
*
Description of need
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Please continue overleaf if necessary
Financial information
Is the family in receipt of state benefits?
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Please specify: Family credit, Income Support, etc.
Can the school/other confirm hardship?
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If the school/other cannot confirm hardship please supply the following:
Source and amount of current income
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Current rent or mortgage payment
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Outstanding loans or similar commitments with repayment commitments
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Amount of savings
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I confirm that to the best of my knowledge the above need cannot be met from a statutory source.
Signed (teacher/other)
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Date
*
For WEF Use (09/2014)
Date considered
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Action taken
*
Payment Date.
*
Submit
Home
History
Governors
Isabelle Spencer Tribute
What we do
Who we help
Isabelle Spencer Awards
Case studies
How we work
Application