The Smile Centre's Local Giving Scheme
The Smile Centre
39 Church Street
Liskeard, Cornwall
PL14 3AQ

Thank you for applying to The Smile Centre's 'Local Giving' scheme. We hope we will be able to support your charity and/or project to achieve something special in the Caradon District.

Before taking the time to complete the application, please read the below information carefully to ensure you are eligible to apply.

All applications must meet the following criteria:

	1.	Your project must be health related.
Please demonstrate in the application ways in which your project will benefit the health of its beneficiaries directly, or promote good health and wellbeing more generally.
 
	1.	Your project must demonstrate good value for money
We are very keen to ensure that the money we donate goes a long way, and are looking for projects that will have a high impact, either through reaching a large number of people, or by making a significant difference to a specific area of need.

	1.	The maximum amount you can apply for is £5,000
£5,000 is the amount TSC is donating annually. If your project costs more than this, please clearly identify which costs you are applying to TSC for. Please bear in mind that if you apply for the full £5,000, we will not be able to award any other projects, therefore we will need convincing that your project deserves the full amount!

Regrettably we are unable to fund salaries, building work or organisational overheads

If you are an individual applying for fundraising support, please refer to our other application form entitled 'Individual Giving'

About you and your organisation:

Applicant's Name and role within organisation:

Applicant's contact details:

Organisation name:

Organisation address:

Charity number (if applicable):

Please outline in no more than 50 words the purpose of your organisation:

How many staff does your organisation employ?

How many volunteers does your organisation work with?

About your project:

Project name:

Project start and finish date:

Please summarise your project in no more than 300 words below:

Please estimate how many people your project will benefit both directly and indirectly:

Can you explain how the health of your projects' beneficiaries will be improved?

Please explain how your project will benefit the local community:

Can you describe the long lasting impact that your project will have?

Please outline here any other information about your project you feel is important:

Costs:

What is the overall cost of your project?

Are you applying to TSC Local Giving for the full amount?

If not, please outline how you will fund the remaining project costs, including details of other funders, decision status and proposed dates you will receive the money:

Please provide a cost breakdown below:

Policies and Insurances:

Does your organisation have an Equal Opportunities policy that is adhered to throughout the organisation? Please provide details:

If your organisation works with children, please provide details of your Child Protection policy:

Please tick which of the following insurances your organisation has in place, and provide details of any other insurances that aren't on the list
 
	⁃	Buildings
	⁃	Contents
	⁃	Event
	⁃	Professional Indemnity
	⁃	Employers' Liability
	⁃	Public liability

Signatures

Applicant signature:
(please clearly write name and role within organisation)

Senior management signed:
(please clearly write name and role within organisation)

Thank you for completing our application form. Following submission, you will be infomred of the next decision date.