APPLICATION FORM
Name & Address of Organisation or Group *
Your answer
Is the Organisation or Group a registered Charity or Not for Profit organisation ? *
Required
Where will the Television be located ? *
Your answer
Who will benefit from the use of the Television ? *
Your answer
How many people will benefit ? *
Your answer
How will they benefit from it ? *
Your answer
Tell us in less the 200 words why you think your application should be the successful one *
Your answer
Contact Name *
Your answer
Contact email address *
Your answer
Contact telephone number *
Your answer
Authorisation *
Required
TERMS & CONDITIONS / CRITERIA
Applications must be received by midnight on Friday 22nd March 2019.
The application must be from or for a Non-profit organisation/group/charity
The television cannot be sold or used as a prize or raffle to raise funds for the organisation/group/charity.
The television must have a permanent location and be used for the benefit of members of the organisation/group/charity and be within 15 miles of our Wimborne Store.
The successful applicant agrees to taking part in local publicity.
Qualifying applicants maybe required to provide further information to confirm that they meet the criteria for receiving the Television.
By completing this applications/nomination form you are giving your permission for the name(only) of the organisation/group to be published on a list of applicants within the Holmans website.
The successful applicant will be chosen by the Holmans Team and notified by email and details published on the Holmans website and other media.
Submit
Never submit passwords through Google Forms.
This form was created inside of Holmans.