COMMUNITY CHEST APPLICATION FORM
Please use this application to apply for funding of a project or specific activity
which will benefit the community in which you live.
(Please see attached guidance notes)
1. Personal details:
Name of lead contact
Address:
Phone Number:
Email address:
Name of group (if relevant):
2. Please give brief details of what you are applying for and why:
3. Please provide details of how much you think the project will cost and give
details of all funding sources. This must include funding received or
requested from any other organisations:
EXPENDITURE
Description of item/activity
Cost
£
Box A
Total Project Cost
FUNDING
Source of Funding
Amount requested from Shropshire
Towns and Rural Housing
Other funding if appropriate:
1.
2.
3.
Total Project Funding
Is this funding
secure?
Y/N
Amount
£
Box C
Box B
Note: Total Project Cost (Box A) must equal Total Project Funding (Box B).
Box C must equal the total amount requested from Shropshire Towns and Rural Housing
in this application.
3 a. Please explain if ongoing costs are likely, how these will be met?
…………………………………………………………………………………………………..
………………………………………………………………………………………………….
………………………………………………………………………………………………….
4. Please detail who will benefit from the project and how:
4 a. How many people do you expect to benefit from this project?
Directly:
Adults:………………………………………Children:…………………………………………
Indirectly:
Adults:………………………………………Children:…………………………………………
4 b. What evidence do you have that this project is needed?
5. If you represent a group, can you confirm if:
Your group has a constitution?
Yes/No
You have a group bank account with more than 2 signatories?
Yes/No
You have public liability insurance?
Yes/No
6. How long will your project take to complete?
6 months/12 months
Signature: ………………………………………………………………………….
Name:……………………………………………………………………………….
Date:…………………………………………………………………………………
I confirm that all information given is true and accurate to the best of my
knowledge and I have read and understand the guidance notes
Office Use Only
Funding application successful Y/N Signed
Applicant notified of decision by letter (date)
Date
Guidance Notes on Applying for Community Chest Funding
Please don’t be daunted by this form, we are here to help you with it, just
give us a call on 01743 210205
Examples of eligible projects
These could include: Educational workshops, setting up a residents group, leaflet
drops, training, diversionary activities. Your project should fall under at least one
of the following categories:
 Safer
- Extra security lighting
 Greener
- Planting of shrubs/plants
 Cleaner
- Litter bins/removal of graffiti
 United
- Projects that encourage better relations between
Neighbours
We will not fund
 Activities promoting a particular religious or political belief.
 Any project that is the responsibility of a statutory body.
 Any projects that do not have a strong and relevant connection to ST&R
Housing communities or its customers.
 Any profit making projects.
 Any projects that are already complete.
 We will not make a contribution of any more than £500 towards any
project.
Notes to assist in completing the form
1. Please give the full name and address of the person(s) applying for the
funding
2. Please give details of what the project is about and the reasons for the
project. Continue on a separate sheet if necessary.
3. Please include the details of how much you think the project may cost,
what funding you would like from us, and what funding you are seeking
from elsewhere. Please indicate if match funding has been applied for or
awarded. Give details of how any ongoing costs are being met.
4. Please identify the expected benefits of your project. Tell us who will
benefit and any other benefits that you expect to see, even if they are not
directly linked to the project (added value). Tell us how many people are
likely to benefit. Include any evidence, such as photos or a survey, to
show us why this project is needed.
5. If you are representing a group, please provide us with some information
about the group. It is not essential for the group to be constituted or have
its own bank account, but we would like to know.
6. Funds must be spent within 12 months of release.
When completed return to: Shropshire Towns and Rural Housing, Sitka
Drive, Shrewsbury Business Park, Shrewsbury, SY2 6LG