On Line Application Form If you are a human and are seeing this field, please leave it blank. Charity Name * Please select Organisation Type Registered Charity or Charitable Incorporated OrganisationCommunity Interest CompanyUnincorporated Association or Charity exempt from registration Charity Registration No. CIC Registration No. Unique Tax Reference No. Year Established Web Site Address Contact * Contact Email * Phone Number * Address * Post Code * Total Income Charitable Expenditure Project Title * Welsh Grant Programme * Social and CommunityMedical SupportChildren and Young PeopleThe ArtsThe EnvironmentNon Welsh Programme Non Welsh Grant Programme Medical ResearchPenal ReformInternational Development Amount Requested Project Budget Current Shortfall Brief Description of Organisation * Brief Description of project to be funded * File Upload (for additional information) Anti Spam Question - Please enter the answer as a number in the box provided 4 + 6 = * Please note - Fields marked with an * are mandatory as is the anti-spam question (above)
