Funding Questionnaire

THIS SERVICE IS ONLY AVAILABLE FOR GROUPS THAT OPERATE IN CHESTERFIELD AND/OR NORTH EAST DERBYSHIRE

Your Contact Details

First Name

Last Name

Address

Address Line 2

City

Postal Code

Phone Number

Email

Job Title

About your organisation

Select an existing Organisation or create a new one if not found

Organisation Name

Organisation Status

Community Group

Registered Charity

Company Limited by Guarantee

Charitable Incorporated Organisation

Community Interest Company

Organisation Status Other

Charity No./Company No. (if applicable)

Does your organisation have a constitution or governing document?

Yes

No

Does your organisation have a committee?

Yes

No

Number of Committee Members (if applicable)

When was your organisation established? (If you are unsure of the exact date please enter the year)

Does your organisation have a bank account?

Yes

No

About your proposed funding

What do you want funding for? (Please give a brief description)

How much funding are you seeking? (Please enter the total cost how much you are seeking)

Please provide a breakdown/budget of your costs e.g. Room Hire for 1 year - £500

Who will benefit?

Which geographical area will it cover? Some funds only cover specific areas

Evidence to demonstrate need?

LINKS CVS WILL AIM TO RESPOND TO YOUR SUBMISSION WITHIN 1 WEEK