Apply for the award

Inspire Award Application

All sections of the application form should be completed and with the permission of your parent/guardians if you are under the age of 18

* Required Field

Section A - Applicant Information

Forename*:

Surname*:

Date of Birth:

Gender*:

Male Female

Ethnicity*:

Registered Disabled*:

Email Address*:

This is the email address we will use to set up an account on the website and start using your blog.

If Under 18, please provide a Parent / Guardian name:

and a Parent / Guardian email:

Your Address*:

Postcode*:

Contact Telephone Number*:

If we need to reach you about your application, we will contact this number.

Section B - Project Information

Name of affiliated organisation (if applicable):

Address of affiliated organisation:

Postcode of affiliated organisation:

Please state amount applied for:

Section C - About your application

Why are you applying for a grant?

What will the fund be used for?

Will you be receiving funding from another organisation? If so please state the organisation.

If applicable - how do you intend on engaging participants?

Please tell us what this would mean to you if you got this award?*

How could this grant help you achieve your aim?*

Have you applied for any other grants from the Joe Humphries Memorial Trust?

If Yes, please state how much was applied for and the outcome of that application?

Section D - Declaration

When will the project start?

When will the project end?

How long will the proposed project be beneficial to your organisation/community?

Please note that if your application is successful you will be required to submit evidence of your age and residence.

Payments of awards will be made in 2 six monthly payments, dependent on criteria of funding requested.

Declaration*:

I confirm that all the information I have given in both my application form and my declaration from is correct to the best of my knowledge and I agree to be bound by the Award Scheme Forms and the terms and conditions.

Please advise the name or the person/organisation you wish your cheque to be made payable to: