Enquiry

Contact Details

First name

Last name

Organisation/Group Name

Telephone

Correspondence Address

Address Line 1

Address Line 2 Optional

Town/City

Postcode

Organisation Address

Different from Correspondence Address

Address Line 1

Address Line 2 Optional

Town/City

Postcode

Which Muirhall Energy project is your organisation based near?

About your Organisation

Date established

Do you have a signed constitution or equivalent? Yes No

Please provide a copy of the signed Constitution

Are you a registered charity? Yes No

Please include your charity number

What are the main activities of your organisation / what services do you provide?

What is the purpose of this application? Sponsorship Funding

Please give as much relevant information as possible about your project

How will this benefit the community?

How much are you requesting?

What is the approximate cost of the project?

When will the project take place?

Please supply an approximate date if unsure

Will you be contributing any of your own funds to the project or undertaking any fundraising? Yes No

Contributing funds details

Approximately how many people will benefit from the project?

What will happen if this application for funding is unsuccessful?

Declaration

By submitting this application form to Muirhall Energy you certify that the information contained in this application is correct, and that if you are awarded funds, you will use it only for the purposes agreed with Muirhall Energy.

You understand that decisions made by Muirhall Energy are final.

Successful applicants will be asked to participate in press/social media relating to the funding provided.

Additionally, you agree that Muirhall Energy can keep your personal details on file, for the purpose of responding to your application. Your contact details will not be shared with any third parties.

Please note: payments cannot be made to personal bank accounts. The name of the bank account MUST match that of the organisation submitting this form.

I/We agree with the above declaration

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