Are all beneficiaries under 25? *

YesNo

Have all beneficiaries lived in Birmingham for at least 5 years? *

YesNo

Do all beneficiaries have a demonstrable financial need? *

Yes No

Name of Applicant *

Address *

Mobile Number *

Email *

Date of Birth *

School last attended with dates *

Name of Organisation *

Address *

Contact Name *

Email Address *

Charity Number (if applicable)

Website (if any)

Job Title *

Telephone Number *

What is the purpose of your organisation? *

Who are your target beneficiaries? *

How is your organisation funded? *

What difference will this award make to your organisation?

How many young people will benefit?

How will you demonstrate that beneficiaries meet the Trust criteria?

Attach your latest Annual Accounts and current Annual Budget *

Amount of money requested *

Brief description of the course, study, or activities including cost details *

Date of Application *

Signature (Type full name) *