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Pre-Application Form
Page
1
of 5
1: Applicants Details
Fields marked with a
*
are mandatory and must be completed.
Name of the owner of the property:
*
Address:
*
Post code:
*
Tel:
*
Fax:
Email:
*
Would you like a copy of this pre-application form sent to this email address?
Yes
No
*
Type of organisation:
(if applicable)
Please select...
Company
Trust
Association
Other (please specify)
Other:
Organisation's registered number:
(if applicable)
Are you a registered charity?
Yes
No
*
Are you a not for profit organisation?
Yes
No
*
2: Contact Details (if different from applicants details)
Your name:
Name of Organisation:
Address:
Post code:
Tel:
Fax:
Email:
Would you like a copy of this pre-application form sent to this email address?
Yes
No
3: Project Details
Fields marked with a
*
are mandatory and must be completed.
Address of property / subject of this application:
*
Post code:
*
Is the building or site designated?
(i.e. listed, scheduled or a registered park or garden)
Yes
No
*
If yes, please give details:
Briefly describe the project and how the grant will be spent.
(Not more than 250 words)
*
Word Count:
Please explain briefly how your project will contribute to the historic environment.
(Not more than 250 words)
*
Word Count:
Please describe the public access and other public benefits to be provided by your project.
(Not more than 250 words)
*
Word Count:
4: Timing
Fields marked with a
*
are mandatory and must be completed.
When could you start work if funding was available?
January
February
March
April
May
June
July
August
September
October
November
December
2008
2009
2010
2011
*
How long will the project take?
*
5: Financial Details
Please tell us how the rest of the project is to be funded by completing the schedule below.
Type of Funding
Amount Raised
Amount yet to be secured
Cash from you / your organisation
£
£
Donations
£
£
Statutory Grants
£
£
Grant-making Trusts & Foundations
£
£
English Heritage
£
£
Heritage Lottery Fund
£
£
Businesses
£
£
Non-Cash contributions and volunteer labour
£
£
Other
£
£
Amount to be applied for from the CHF
£
n/a
£
Totals
£ 0
£ 0
Estimated total cost of project
£ 0