Project Idea Form

* Denotes a mandatory field

Organisation name *

What is the legal name of your organisation as shown in your governing documents?

If your organisation is known by any other name, please put this in brackets after the legal name of your organisation.

If your organisation has no legal status at this time please simply state the organisations name, please note you will need legal status before any grant can be awarded. If you require advice on how to obtain legal status please contact KSB for more information.

Organisation type *

What is the legal status of your organisation? e.g Not-for-profit distributing community group, Company limited by guarantee, community planning partnership etc. [If none at this stage please state none however you will need legal status before any grant can be awarded]

Address *

Postcode *

Phone number *

Fax number

Web address

Contact name *

Title Select Mr Mrs Miss Ms Dr

Phone number *

Fax number

Email address *

Address

Postcode

Phone number

Fax number

Web address

If the address for correspondence is different from the organisation's registered address please state why here.

Name of project *
(in not more than 12 words)

Summary of Proposal including measures to demonstrate reduction in carbon emissions *
(Please describe your Proposal in no more that 500 words)

Proposal start date * (dd/mm/yyyy)

Proposal end date * (dd/mm/yyyy)

Year 1 (£) *

Year 2 (£) *

Please estimate how much funding you require from CCF over the length of the proposal

Year 1 (£)

Year 2 (£)

Please list any other potential or planned sources of income for your proposal

Source 2009-2010

Source 2010-2011

Delivery partners & roles include roles envisaged for each partner

We will use the information you give us on the Expression of Interest Form assessment and for the life of any grant awarded to you to administer and analyse grants and for our own research. We may give copies of this information to individuals and organisations we consult when assessing applications, when monitoring grants and evaluating the way our funding programmes work and the effect they have. We may also share information with government departments, organisations providing matched funding and other organisations and individuals with a legitimate interest in CCF applications and grants, or for the prevention or detection of fraud.

We recognise the need to maintain the confidentiality of vulnerable groups and their details will not be made public in any way, except as required by law.

I declare that the information I have given on this form is correct and complete. *

Name *

Position in Organisation *