QPSW Simmons Grant Application Form (2024)

Simmons Grants are available to overseas projects that enable rural young people to become self-sufficient or for other similar educational purposes.

Please refer to the Guidance Document and to the specific notes referred to below when completing this form. Information provided is CONFIDENTIAL.

Please provide information for ALL the questions on the form - * indicates required field to move to the next page

Grant request: {19. Please state the amount of the Simmons Grant requested for 2024::29} (from question 19)

1. Reference:

See note 1

2. Project Name:

A) Contact Details

Project Contact See note 2

3. Name: *

First Last

4. Address:

Building name / number Street address Town / City County Postcode

6. Phone:

7. Fax:

8. Email: *

A copy of your completed form will be sent to this email

Enter Email Confirm Email

9. Website:

B) Quaker Connection

10. Please explain how Quakers are involved in supporting this project (e.g. as trustees, volunteers, giving financial support, giving spiritual support). Indicate here how this is demonstrated by letter(s) or minute(s) of support submitted with this application.

See notes 3 and 4

C) The Project

Management See note 5

11. How is the organisation managed?

12. Is it a registered charity?

Yes

No

Unsure

13. Charity number, if known:

Description See note 6

14. Indicate briefly the purpose of this project:

15. Indicate briefly how the project arose:

16. Please describe the project and explain how it will assist the people concerned to establish a more self-sufficient position or similar purpose.

See note 7

17. Please itemise, with costs, the specific purpose(s) for which a QPSW Simmons Grant would be used (e.g. staffing costs, planning and development, capital equipment, consumable materials, fees). If the grant applied for will not cover the whole cost, please include the expected total budget figure for the project.

See note 7

D) Financial Details

18. Please outline the general financial position of the project including details of any other money requested, promised or received so far (e.g. from statutory bodies, other trusts, banks or individuals.

See note 8

19. Please state the amount of the Simmons Grant requested for 2024:

Please input a positive amount up to £2,000

20. If the grant is to be spent outside the UK, are there any existing or planned arrangements for the transfer of funds overseas? If so please give details.

See note 10

Details of any existing bank accounts for the project See note 14

21. Name of account 1:

22. Name of bank:

23. Address of bank:

Street Address Address Line 2 Town / City Postcode

24. Sort code:

25. Account number:

26. Swift code:

27. IBAN:

28. Name of contact for person account 1:

First Last

29. Address:

House name / number Street address Town / City Postcode

30. Phone:

31. Email:

Information for bank account 2 is optional

32. Name of account 2:

33. Name of bank:

34. Address of bank:

Street Address Address Line 2 Town / City Postcode

35. Sort code:

36. Account number:

37. Swift code:

38. IBAN:

39. Name of contact for person account 2:

First Last

40. Address:

Street Address Address Line 2 Town / City Postcode

41. Phone:

42. Email:

E) Attachments

See note 11

Please upload files here:

Drop files here or

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 2 MB, Max. files: 5.

(Click to the right of "100%" on the uploaded document to remove it)

F) Declaration

I apply for a QPSW Simmons Grant (2023) of: {19. Please state the amount of the Simmons Grant requested for 2023::29}

Signed: *

By typing your name above, you are signing electronically.

Date: *

G) Personal Data Consent

We collect data on this form for the purpose of processing grant applications. We will only ask for personal data which is limited and relevant to the administration of the grant. This data will be held securely and will not be shared with any third parties without your notification and consent if required. If we transfer data outside the EEA, for example to systems providers in the US, we will ensure they are GDPR compliant. We will retain this data for a period of six years in compliance with financial best practice under the Limitations Act (1980). Grant decisions may be minuted by a committee. These minutes will be retained permanently under BYM retention policy for historical purposes. Where minutes contain sensitive personal data they will remain closed to the public for 100 years.

Britain Yearly Meeting is the Data Controller. Should you wish to access the data we hold on you, please contact BYM Data Protection group (link here). Should you wish to complain about our processing of your data, please contact: www.ico.org.uk.

Do you actively consent to our processing of the data you have given under the above conditions? *

Yes, I consent

Should you wish to withdraw your consent at any time, please contact: grants@quaker.org.uk.

Form review: Please review the information you've filled out below. If there are any changes you wish to make, please go back through the form and edit prior to your submission.

{all_fields}

For any questions about this form, please email the Grants Officer at grants@quaker.org.uk.

Friends House, 173 Euston Road, London NW1 2BJ, Telephone 020 7663 1000.

To be able to submit this form, please ensure there is a positive value in Financial Details, question 19.

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QPSW Simmons Grant Application Form (2024)

A) Contact Details

B) Quaker Connection

C) The Project

D) Financial Details

E) Attachments

F) Declaration

G) Personal Data Consent