Please make sure that you have read the grants criteria fully, before submitting an application and complete all sections.

Section 1 - Information about the Organisation

Name of Organisation requesting a grant

Cheque to be payable to (if different from above)

Website (If Applicable)

Name of the main contact for this application

Address

Telephone Number

Email Address

Section 2 - Information about the organisation requesting funding

Please provide an outline of the organisation that will be benefiting from this project, or purchase, to include its objectives, recent achievements and target beneficiaries.

From the organisation's most recent set of annual accounts, please fill out the information below:

Total income received

Total amount of expenditure

Total amount carried forward

Total amount of unrestricted funds

Section 3 - Information about the grant being requested

The following section requests information relating to the purpose of the grant you are requesting. Please provide as much information as possible within this form and refer to the Kearns Foundation Grant Criteria carefully before answering these questions.

What is the total cost of your project? (You will need to supply copies of estimates, quotations if your application is successful to support your figures here)

How much money are you asking for from The Kearns Foundation? (Grants are normally awarded for between £50 and £250)

If this amount does not cover the whole cost of your project what are your plans for finding the difference?

What will the money granted be used for? (please give details or equipment/services being purchased or provided with the grant)

Who, and how many people, will benefit from the grant?

What difference will this grant make to the community, and in particular to those people aged under 18?

How does this application meet our criteria of ‘making a little money make a big difference?

When will this project/purchase take place?

Which local government (District council) area of Norfolk will most benefit from this project?

Please give details of someone who could we contact as an independent referee for your application. (This should be someone outside of your organisation who could speak about the work of your organisation)

Full Name

Relationship to the Applicant

Telephone Number

Email Address

Section 4 - Declarations

Before submitting this request, please check all the statements carefully. By applying for this grant, you agree to the following declarations.

  • All the information given in this application are correct to the best of my knowledge
  • I am authorised to act on behalf of the individual/organisation that may benefit from any grant awarded
  • I have read and understood the grant criteria
  • I understand that if this project does not go ahead, or the individual or organisation applying for the grant, is in breach of the grant criteria, that The Trustees of the Kearns Foundation reserve the right to demand repayment of all, or part of the grant made.
  • I undertake to acknowledge The Kearns Foundation for any grant awarded in publicity relating to this project.
  • I understand that if a grant is awarded I will need to supply evidence of estimates and quotations used, as well as copies of accounts and bank statements (organisations only)
  • I undertake to provide The Kearns Foundation with a short report on completion of this project/purchase or within 12 months of the grant award, whichever occurs first.