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INITIAL APPLICATION FORM

We have designed this form so that applicants can support their requests for grants from the Tobacco Pipe Makers and Tobacco Trade Benevolent Fund. Please read the information on our website about how to apply and what we are looking for before completing and submitting the form.

Please try to keep your responses to the questions brief (no more than 250 words if possible). We hope the information we request – a mixture of basic information about how the charity works plus some simple due diligence questions – is not overly onerous. If you have any comments on the application form itself please feel free to add them to box 17.

We will use your completed form as the basis for considering your application, along with other information in the public domain that we might choose to access (eg report and accounts).

This form can be completed online, alternatively you may download a PDF version of the form which should be emailed to to the Secretary of the Benevolent Fund, Sandra Stocker (benevolentfund@tobaccolivery.org) along with supporting documents.

Documentation required:

  • Any other material, such as a brochure, that you think may assist the Trustees in their decision-making;
  • A copy of your charity’s safeguarding policy (if you work with young or vulnerable people).
  • 
A copy of your charity’s governing document (eg articles of association).
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The Tobacco Pipe Makers & Tobacco Trade Benevolent Fund

1. Name of applicant charity

2. UK registered charity number

3. Charity website (if applicable)

4. Registered address of the charity

5. Principal contact details for the applicant Name Role in the organisation Email address Telephone

6. Please tell us who the charity helps
eg young people, the elderly, vulnerable, from particular backgrounds, etc

7. In which cities or regions does your charity operate?
Please let us know if you are applying for a project with a different or more specific location

8. Is this a one-off request to support a particular project? If so, please describe the project below.
If this is a request for general funding, please move to question 9.
Aims of the project Who the project is designed to help Cost of the project, and how much funding needs to be raised Amount you would like us to consider donating Duration of the project

9. Is this a request for general funding for your charity? If so, please provide details below What a grant would be spent on Who the grant is designed to help Your charity’s annual fund-raising target and sources Amount you would like us to consider donating

10. What outcomes are you expecting to achieve with the help of a grant from us, and how will you measure them?

11. Does your annual report set out your charity's structure and details of how it is managed, including how it recruits trustees
If your response is no, please add that information below

12. How did you hear about us?

13. If you or someone at your charity has a link to one of our trustees, or a member of the Worshipful Company of Tobacco Pipe Makers & Tobacco Blenders, please could you briefly describe that relationship?

14. Please select either the 'yes' or 'no' boxes to confirm whether or not your charity has the following policies in place: Privacy Policy YES NO Adequate indemnity insurance for trustees and key personnel YES NO If your charity works with young or vulnerable people, DBS certificates for all relevant employees or others working with the charity YES NO

15. If your Charity has received notifications of concerns from the Charity Commission, adverse press coverage, or if any of the trustees is the subject of a complaint or investigation (in each case during the past five years) please provide details below or type "None"

16. Please provide contact details (preferably email and / or phone number) of two referees who can provide a reference regarding the charity’s effective delivery of its services. The referees must be external to the organisation and be happy to be named and contacted by us, and should not be related to any staff or volunteers of your charity.


17. Is there anything else you would like to tell us?

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