(Just working out the draft form – this page isn’t public)

If this grant is for you



Address (if you don’t have a permanent address just let us know where you’re living at the moment)

If this grant is for somebody else

Does recipient know you are doing this? [Tick: Permission to contact recipient directly?]

Your name, phone/email

Recipient name, phone/email

Recipient address (if they don’t have a permanent address just let us know where they’re living at the moment)

What is this grant for?

Multiple tick boxes:

    • Rent
    • Food
    • Bills
    • Other (space to write what)

How much do you need (up to £100)?

How do you need to receive the grant:

    • Bank transfer [space for acc no and sort code]
    • Cash
    • Grant is for someone else – they will give you this information

Data protection statement

I understand that the information provided on this form will be seen by Machynlleth Corona Solidarity Fund’s core volunteers, will be handled in the strictest confidence and not shared outside of this group, and will not be stored any longer than necessary for grantmaking and record-keeping purposes. I am happy to share the above information with the group on these terms.

    • Tick to accept

Form submission then goes to acknowledgement page:

Thank you, your application has been received. We will be in touch soon.

(this is also sent via email if an email address is given.)