Supporting Communities Fund: Pollokshields Application

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* 1. Application Details

Contact Person Name *

Company Name *

Flat Number (If applicable) *

Address *

City/Town

ZIP/Postal Code *

Email Address ('N/A' if you do not have one) *

Phone Number *

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* 2. How much funding do you require? (Max £2,000)

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* 3. Give a brief overview of the support you are providing the Pollokshields community in relation to Covid-19 and how you intend to use this funding below:

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* 4. Please provide a budget breakdown below:

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* 5. Name of Bank:

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* 6. Bank Account Name:

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* 7. Sort Code:

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* 8. Account Number:

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* 9. I confirm that I am authorised by my organisation to apply for this funding and that we will comply with the terms and conditions. Click here to view the terms and conditions.

Yes

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* 10. Signature (please type name)

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* 11. Date

Please enter date of application submission

Date