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Please read the following before completing the form below:


1. We can only offer help to organisations who offer support to older people.


2. Organisations applying must operate in the Ancient Parish of Titchfield (see map on our homepage)


3. All applications will be assessed on an individual basis by a voluntary Trustee who may wish to visit the applicant/organisation. You may also be invited to attend one of our Trustee meetings to give further information to all Trustees about your application. Funding is not guaranteed.


4. Further to a grant being approved, Trustees may request a follow-on visit with the applicant/organisation for feedback on the how the grant was spent.

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If you have any issues or need help completing your form, please contact us.

Support For The Elderly

Application Form
(Organisations)

Section 1. Applicant Details

Section 2. Organisation Details

Has the Earl of Southampton Trust helped you before?
Yes
No

Section 3. Declaration

I declare that all replies on this form are correct in all respects and understand that any misleading information may disqualify the organisation from the benefit now and in the future. By signing this application, I confirm that I give the Earl of Southampton Trust permission to contact me. I understand that my data is collected and processed in accordance with the Trust's Data Protection Policy and I can ask to see a copy of the same.

Data Protection: By signing this form, the applicant agrees to the information on the form being stored in the Earl of Southampton Trusts manual filing system and summarised on the computer for the sole purpose of grant processing, analysis and accounting. All information will be treated in the strictest confidence and will not be divulged without the prior agreement of those concerned.

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