Grant Application Form Name of Applicant*FirstLast Applicant's Age* Have you applied to Clingan's Trust before? If so when and with what result (please note this does not mean you will not be considered for a further grant)*YesNo When did you last apply? What was the result of your previous application? Applicant's Date of Birth* Place of Birth Home Address* Street Address Street Address Line 2 Town / City County Postcode Your Telephone Number* Your Email Address* Is your correspondence address different? (ie. if you are living at university or away from home)YesNo Correspondence Address Street Address Street Address Line 2 Town / City County Postcode Your Status*Please select...StudentApprenticeEmployedSelf-EmployedUnemployed Name of your Current Education Provider (for example school, university, employer if you are an apprentice) Address of Current Education Provider / Employer* Street Address Street Address Line 2 Town / City County Postcode Please provide details of your current course or activity (for example A-Levels, Apprenticeship, Degree etc.)* When did the course commence? When will the course end? Is the course full-time or part-time? (for example you may have day release from your employer if you are an apprentice)Full-TimePart-Time Please list any schools or places of education previously attended:* Please list any previous qualifications with grades (for example GCSEs, A-Levels, Degrees, music grades, Duke of Edinburgh Award etc):* If you did not go into further education immediately after leaving school what did you do in the interim? For example a gap year, employment. Please give full details: What career do you wish to follow? (if known): For how much are you applying?* For what purpose are you requesting a grant?* Have you applied to any other organisation for financial help and if so to whom and with what result? Do you have any income of your own? For example for a weekend/evening or holiday job or from any family trust or inheritance. Please give details: Do you have any savings? If so please state the amount: Do your parents/guardians make any contribution towards your college or university expenses? If so, how much:REFEREEThe Clerk may need to obtain a reference in support of your application. The reference is confidential and will only be shown to the Trustees. Please nominate a person and give his or her address. This could for example be a teacher, lecturer or a person running an out of school activity.Please note it is important that you obtain your referee’s permission to give us their details before passing them to us. Name of your Referee* Position Held Referee Address* Street Address Street Address Line 2 Town / City County Postcode IF you wish to provide further information which you feel will be helpful to the Clerk please add your comments here: IF you are awarded a grant it may at the Trustees discretion be paid direct to a school or college or a parent. However please specify to whom you wish the cheque to be made payable. Full names of parents/guardians/step-parents Addresss of parents/guardians/step-parents Street Address Street Address Line 2 Town / City County Postcode Occupation of parents/guardians/step-parents The parental and household income is: And this amount:weeklymonthlyannualNote. This is the NET income after deduction of income tax and national insurance. You should also include any adults in the home who are working and contributing to the household expenses and any parent who does not live in the home. For example partners, brothers and sisters, grandparents. It is helpful, but not essential, if you can provide evidence. Please give details of any monthly mortgage or rent payments Who else resides at this address? Do the persons referred to in questions 1 and 6 above receive any benefits?For example, housing benefits, free school meals, working tax credits, disability benefits etc. Please give details of the type of benefits received (it is NOT necessary to detail any health details in connection with benefits received).IF you have reached this stage, you are now at the end of the application form.Please ensure that all required fields have been completed accurately to the best of your knowledge before clicking the Submit button below.SubmitReset
