S4GI Form - Cellnex

Section 1: General Information

Name of Organisation or Group(Required)

Email(Required)

Website(Required)

Phone(Required)

Correspondence Address (Including Postcode)

Organisation Address (including Postcode)

What are the main activities of your organisation? What service(s) do you provide?(Required)

Who benefits from your organisation or group and how?(Required)

What’s your charity number?(Required)

Does your organisation require membership?(Required)

How many members does your management committee have?

How many regular volunteers do you have in addition to your management committee?

How many full-time staff do you employ?

How many part-time staff do you employ?

How many members does your organisation have?

Section 2: Financial Information

What’s your organisation’s main source of income?(Required)

Total income last accounting year? (New groups: projected income in first year)(Required)

Total Surplus/Deficit last accounting year?

Current unrestricted reserves

Why can’t your reserves be used for this project?

Section 3: Grant Application

Please describe the project you are looking for Cellnex UK’s S4GI Community Benefit Fund to fund

Please describe how the community

Is this a new project?(Required)

If your project is already running, please describe how it has been funded to date.

Can you give examples of other successful community projects you have carried out?

How will you maintain/ sustain your project after the period of funding is finished?

Does your project require any permits or planning permission? If so, are these in place? Please give details.

How much are you applying to Cellnex UK’s S4GI Community Benefit Fund for?

How much does your project cost?

Please provide, or attach separately, a full cost breakdown of the whole project and indicate which elements you are requesting from this fund. Please enclose quotes or evidence where possible.

What other sources of funding have you applied for?

Name of Funder(Required)

Number

Confirmed funding?

Date Confirmed

Will you be contributing any of your own funds to the projects or undertaking local fundraising to help meet the costs? If so, please state how much and how these funds have been raised.

Who will manage project and carry out the work required?(Required)

How many people will benefit? Please tell us how you have worked this out.

When does your project start/finish?(Required)

What will happen if we can’t award you this grant?(Required)

Details of independent referee

Phone(Required)

Organisation(Required)

Position(Required)

Relationship to your organisation(Required)

If your grant is successful, please specify who the award should be made payable to. This must not be an individual’s bank account and must be an account where two signatories are required.

Account name(Required)

Section 4: Checklist

We have appropriate procedures in place to carry out our project safely(Required)

We have provided contact details of an independent referee(Required)

I can confirm this project doesn’t require retrospective funding(Required)

I have included the following documents with my application:

A signed copy of the organisation’s constitution

Upload organisation’s constitution

Max. file size: 20 MB.

The organisation’s latest annual accounts (independently verified)

Upload the organisation’s latest annual accounts

Max. file size: 20 MB.

Project budget plan

Upload project budget plan

Max. file size: 20 MB.

A copy of the organisation’s Child Protection/Vulnerable Adult Policy (if applicable)

Upload the organisation’s Child Protection/Vulnerable Adult Policy (if applicable)

Max. file size: 20 MB.

I have attached additional information with this application (please detail below)

Cellnex UK S4GI Community Benefit Fund - Application Form

Section 1: General Information

Section 2: Financial Information

Section 3: Grant Application

What other sources of funding have you applied for?

Details of independent referee

If your grant is successful, please specify who the award should be made payable to. This must not be an individual’s bank account and must be an account where two signatories are required.

Section 4: Checklist

I have included the following documents with my application: