Application Form

Please complete all of the sections below no later than midnight on Sunday 11th October 2015. If you get stuck refer to the Application Guidelines document for help - Good Luck!

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* 1. Your name (first name and surname):

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* 2. Your email address:

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* 3. Your phone number:

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* 4. The name of your project:

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* 5. What type of organisation are you?

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* 6. Address of your project:

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* 7. Postcode of your project:

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* 8. Number of people involved in the project:

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* 9. Link to project page on Project Dirt or website/blog (if you have one):

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* 10. I am applying for:

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* 11. Please provide a brief background to your community project:
(200 words max)

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* 12. Please outline what you hope to achieve with the money:
(200 words max)

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* 13. How will the funds be spent?
Please provide a breakdown of the items and their cost
(200 words max)

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* 14. What will the environmental benefits be?
Please be as detailed as possible
(200 words max)

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* 15. Are there any wider/secondary benefits from getting this funding?
Think about the wider social/community benefits created as a result of your project
(200 words max)

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* 16. Would you welcome pro bono legal advice or other volunteer support from Mishcon? If yes, what would it be for? (200 words max)

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* 17. Is there any other information you feel is relevant to your application?
Have you received match funding or other support etc?
(200 words max)

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