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Grant application form

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Funding Application Form

Section 1 – Organisation

Address:
Main contact person:
What type of organisation are you?

About your organisation

Section 2 – Your Project/Activity

DD slash MM slash YYYY
DD slash MM slash YYYY
Outline the aims and objectives of your project.

Section 3 – Project Budget

Have you applied for other sources of funding for this project?
Breakdown of the total budget:

Section 4 – Bank Details

In the event that a grant is awarded, we will make payment via BACS directly to your organisation’s bank account. Please complete the details below.

Section 5 – Supporting Documents

Please provide us with your supporting documents by attaching them to this application. If this is not possible then, please e-mail them separately.
Max. file size: 16 MB.
If your project involves working with children or vulnerable people, please confirm that your staff / volunteers have the appropriate DBS checks in place.

Terms & Conditions

  1. The organisation, if successful, shall use the grant funding only for the purposes as set out in the original application and the Letter of Offer.
  2. The organisation shall acknowledge GEM Road Safety Charity’s (The Charity) contribution to the project in all publicity and marketing (including on social media) and will provide The Charity with a copy of all articles published in the media.
  3. The funding will be spent by the organisation with due account to efficiency, value for money and effectiveness.
  4. The organisation will inform The Charity as soon as possible should it not be able to spend the grant funding on the purposes for which it was awarded. In such circumstances the grant amount is to be refunded to the Charity.
  5. The organisation will inform The Charity as soon as possible if the full project will not be delivered due to a failure to secure any additional funding required. In such circumstances any remaining monies, or the full grant, shall be refunded to the Charity.
  6. The organisation will, within two months of the completion of the project for which grant funding was awarded, submit a short monitoring report or other monitoring data as stated in the application or as otherwise agreed with The Charity.
  7. The Charity can request repayment of all or some of the grant funding in the event of the organisation’s failure to meet these Terms and Conditions.
  8. By signing the declaration, the organisation is accepting that The Charity can use details of the project, including images provided, for publicity and marketing purposes. If there is a safeguarding or other significant reason why this is not appropriate it must be agreed by The Charity prior to acceptance of the grant.
  9. The Charity accepts no responsibility, financial or otherwise, for expenditure or liabilities arising out of the work of the organisation. The organisation fully indemnifies The Charity against all claims, actions and demands howsoever arising. The organisation confirms that any insurances, permissions or legalities required will be obtained or complied with respectively for the duration of the project.
Declaration
I am authorised to make an application on behalf of the above organisation. I certify that the information contained within the application is correct and if it changes in any way, I will inform the GEM Road Safety Charity. By signing this declaration, I am agreeing to the above terms and conditions on behalf of the applying organisation.
(Required)

The GEM Road Safety Charity champions initiatives that bolster road safety across England, Wales, Scotland, and Northern Ireland. From 1985 onwards, we've provided funding to various schemes throughout the UK. The Trust was founded with the objective of enhancing road safety and minimising the fatalities and serious injuries on Britain’s highways. This continues to be our core mission.

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Guild of Experienced Motorists Road Safety Charity, Charity Number 326857. Registered Office: Station Road, Forest Row, East Sussex, RH18 5EN.

Trustees:

Laura Ward (Chairman)
Martin Cooke
Ben Johnson
Gill Starkie
Emma Tugwell-Smith

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