Goodliff Fund: Application Form

Applicant

Name and address of person or institution:

Telephone:

Name and address for correspondence if different:

Telephone:

General purpose of grant (see Information for Applicants note 2):

Description of proposed research, project, etc. Please give all relevant details available, even if only tentative:

Total cost (where relevant give details of supplier and enclose quotations):

Minimum grant which would allow the project to go ahead:

£ Enter here any other sources from which grant aid is being sought or is promised, including amount(s):

If the grant is for a museum, archive etc., acquisition or equipment who will be the legal owner?

If applicant is institution, society, etc., does it have charitable status?

When would the money be required?

Anticipated completion date?

Name and address of referees:

Any other relevant information:

Declaration: I apply for grant aid for the above project/ research. I accept the conditions referred to in Information for Applicants.

Signature:

Designation (for institutional applicants):

Applications to be sent to:
The Goodliff Fund Administrator
5 Grainger Avenue
Godmanchester
Huntingdon
Cambs PE18 8JT