Grant Application Form

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Wellington Chaplaincy Trust Grant Application Form

This form is for applications for grants from the Wellington Chaplaincy Trust Board (Trust)

Notes for applicants:

Please review the Grants Policy before lodging your application. It is available here:
www.whct.org.nz/grants-policy
You may use this online form or download and fill out our pdf form electronically and send to:
whctor2@whct.org.nz. You can also download the form, fill it out by hand and send it to us:
WHCT Grant Applications, P.O. Box 12-397 Wellington.
The Trust will endeavour to respond to applications within three months of receipt.
Please direct your referees to separately email their statements of support for your application:
whctor2@whct.org.nz

Please complete all sections of this application and send.

Any relevant attachments can be emailed to: whctor2@whct.org.nz

Name of organisation *

Name of applicant / contact person *

Position in organisation *

Address *

Phone *

Email *

Please provide a description of the project (including who will benefit) in the panel below.
Please email any supporting information separately if required to: whctor2@whct.org.nz

$ Amount applied for *

$ Total cost of the project *

$ Funds already available *

Referee 1: Name, Address, Phone, Email *

Referee 2: Name, Address, Phone, Email *

Other grants applied for

I/We have supporting documentation which will be emailed to WHCT separately

I/We the applicant(s) confirm that I/we have read and accept the Application Guidelines and I/We acknowledge that if a grant is made my/our organisation may be asked to acknowledge the grant from Wellington Hospital Chaplaincy Trust publicly.

I/We the applicant(s) confirm that Wellington Hospital Chaplaincy Trust may collect information about our organisation from third parties in respect of this application.

I/We Confirm the above *