1. Name of organisation or individual making application:-
2. Name of Contact person:-
E-mail:-
3. Aims and objectives of the group or individual:-
4. Aims and objectives of the project (what does it do, or hope to do?):-
5. Please give breakdown of costs where project does not take the form of a printed publication:-
Total: £ .
6. Where the project takes the form of a printed publication, applications should be accompanied by the manuscript, and costings must be supported by quotations from three printing firms. (a) Please give a breakdown of the costs of the project:-
Proposed publication date: Number of Pages: Illustrations: Format: Paper: Type of binding: Print run: Cost per copy: Proposed selling price: Proposed selling price if grant awarded:
7. What is the amount of grant sought: £
8. Have you applied to any other sources for funding for this project? If YES, please give details of all grants received or applied for:-
Organisations should enclose any other relevant information, e.g. copy of Constitution, names of officers, information leaflet, copy of last annual account etc.
Position:- .. Date:- .
Return to: The Administrator, Ulster Local History Trust, Mrs V Herbet, 18 Clonoag Valley, Lisnaskea, Co. Fermanagh, BT92 0LJ.
FOR OFFICIAL USE ONLY. |