Online Application Form

This form must be completed by a person aged 18 or over. This is the Applicant.

We provide funding for young people aged between 14-18, who is the proposed Beneficiary. The beneficiary may complete this form only if they are aged 18 or over at the time the form is submitted, in which case they will be both the Applicant and the Beneficiary. In most cases however, the Applicant will be the Beneficiary's parent or carer.

The Applicant should complete all of the fields below. Please select the information button next to any of the fields to reveal further advice and guidance on how to complete the field.

APPLICANT'S DETAILS

NB: The applicant must be 18 yrs or over

Title Forename Surname
Relationship to Beneficiary

Address 1
Address 2
Town/City
Post code

Telephone: Day Evening

BENEFICIARY'S DETAILS

Forename Surname Male Female
Date of Birth Please enter d.o.b. in format DD/MM/YYYY

Address 1
Address 2
Town/City
Post code

Current Main School/ College
School or College Town/ City
Headteacher/Principal's Name

COURSE/ACTIVITY

Providing Organisation

Address 1
Address 2
Town/City
Post code
Country if not UK
Telephone

Title of Course/Activity
Venue/Location
Course Date/s
Course Fees/Cost £

Residential

Non -Residential

MUSICAL EXPERIENCE

Preferred Instrument
When started learning to play
Qualification or Grade Achieved

Summary of Any Other Musical Experience:

FAMILY CIRCUMSTANCES

The information you provide here will be seen only by the Charity's trustees in order to help them to decide about whether to offer you a financial award, except that a summary of this information may be passed to your chosen referee.

Please enter the number of adults (18 or over) and the number of children (under 18) in the beneficiary's family who normally live at the beneficiary's home address (including the beneficiary)

No. of Adults No. of Children

Select the amount shown below that most accurately represents the total income over the last twelve months added together of all the adults and all the children included above, including all earned and unearned income:

£15,000 or less	£15,001 - £25,000	£25,001 - £35,000
£35,001 - £45,000	£45,001 - £55,000	More than £55,000

Use this space to tell us anything else about the beneficiary's or the family's circumstances that you feel will help us to make a decision about this application:

REFERENCE

Please enter the details of someone who has consented to be approached by us for further information about your circumstanceds and musical potential:
Name of Referee
Post held or Professional Status
Address 1
Address 2
Town/City
Post code
Telephone
Email Address

AMOUNT REQUESTED

Amount requested towards costs of course fees £
Amount requested towards travel costs £
Amount requested towards other costs £
Total amount requested £
Give further details of any amounts requested above under Travel and/or Other Costs

If you or anyone else has applied or intends to apply for a grant towards the costs of this course/activity from another charity or similar body, give details of the organisation and the amount requested:

DECLARATION BY PARENT/CARER I/we, the parent/s or carer/s of the beneficiary, consent to this grant application being submitted, and will do everything I/we can to enable the beneficiary to attend, participate fully in and gain long-term benefit from the course/activity. NB: The beneficiary's parent/carer must check this box to indicate their support for this application

Parent/carer's name/s Please enter the name/s of carer/s making this declaration

DECLARATION BY APPLICANT I, the Applicant, confirm that all of the information on this application form is true and accurate to the best of my knowledge. NB:The applicant must check this box to verify the truth and accuracy of all elements of this application

Applicant's Name Please enter your name here
Email Address A email address is required.Please enter a valid email address Date

FINAL SUBMISSION

NB: Once you click the button below, your application will be processed and sent to us in electronic form for consideration.

No financial award will be approved without a printed and signed hard copy of this application, so if your application progresses we will send you a copy in due course for you to print out, add signatures and return to us.