Educational Charity - application form

ACTON (MIDDLESEX) CHARITIES

EDUCATIONAL CHARITY

Registered No. 312312

IMPORTANT

All applications received during the period 1 September – 30 November will be considered for grants, according to the protocol below. All applicants will either receive the usual grant of £300 in December, or will be informed that their application has been unsuccessful. If there are more applications than funds, those with similar qualifications will be considered by date of receipt. If any funds remain available after all received applications have been processed, any further applications will be considered on a first-come-first-served basis.

Applications will be processed in the following order:

1. First-year applicants: students entering on their first year of study.
2. First-time applicants: students who are already engaged on a course of study but are applying to us for support for the first time.
3. Continuing students who have received a grant in the past, and are taking a three-year course.
4. Continuing students who have received a grant in the past, and are taking a course of more than three years.
5. Post-grad students.

When you send the form, include with it written proof from your place of education that you have begun the session, and showing the subject(s) of your course. NB This has to be sent every year you claim – no grant can be considered without it.

PLEASE PRINT CLEARLY

Full name of student. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Home address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postcode. . . . . . . . . . . . . . . . . . . .         Tel. no. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Email address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date of birth . . . . . . . . . . . . . .  . . . . . . . . . . . . .    Place of birth . . . . . . . . . . . . . . . . . .. . . . . .

Nationality . . . . . . . . . . . . . . . . . .  . . . . . . . . . .     Length of residence in Acton . . . . . . . . . . .

Schools attended:  First/Primary school . . . . . . . . . . . . . . . . . . . . . .

Middle/Junior . . . . . . . . . . . . . . . . . . . . . . . . . . .

Secondary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

University/other . . . . . . . . . . . . . . . . . . . . . . . . . .

Details of course, and qualification aimed at: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..

Date of entry to course . . . . .. . . . . . . . . . . . . . .   Year of the course (e.g. 1^st, 2^nd) . . . . . . . .

Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Date . . . . . . . . . . . . . . . . . . . . .

Cheques will be sent out in December to the address given above; please provide an alternative address for this if necessary

Send the completed form to:

Clerk, Acton Charities, c/o St Mary's Parish Office,

1 The Mount, Acton High Street, London W3 9NW

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