Torfaen Young People's Music & Arts Trust

Applicant's Details

 

Title:                                  Please select... Mr Miss Mrs Dr

 

Forename(s):                 

 

Surname:                        

 

Address 1                         

 

Address 2                        

 

Town:                                 Please select... Blaenavon Cwmbran Pontypool

 

Postcode:                         

 

Tel. No.:                             

 

D.O.B. (dd/mm/yyyy):      

 

Background

 

Are you in full time education?                                                      Please select... Yes No

 

If yes, please state name of school, college or university:     

 

 

Are you currently employed?                                                          Please select... Yes No

 

If yes, who is your employer?                                 

                      

 

Achievements

 

Please outline the standard of any certificates or examinations you have achieved and outline details of any courses or summer schools you have attended or any competitions entered:

 

 

Reason for Application

 

What is the assistance required for?

 

 

What is the total cost of the item/course etc?                          £

 

Are you seeking funds from any other organisation?                Please select... Yes No

 

If yes, please give details. 

 

 

Supporting Information

 

Please detail any information you would like to submit in support of your application which demonstrates your dedication and loyalty to your interest. 

 

 

Referee

 

Please provide the contact details of one professional referee:

 

 

The Torfaen Young People's Music and Arts Trust Fund is supported and administered by Torfaen County Borough Council but decisions in relation to funding applications is solely the responsibility of the Trustees.

 

 

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