Conservation Grant Application Form

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The Society requires an application form to be completed to consider your application for a grant. It must be supported by an estimate from a recognised brass conservator.

 

 

Please complete the details below, then print the from using the browsers print button (or use the menu File ... Print ) then send the form and the estimate to:

 

M Stuchfield F.S.A.

Lowe Hill House

Stratford St Mary

Suffolk

CO7 6JX

 

 

 

 

 

APPLICANT (i.e. Body or organisation applying for grant)

 

Title

Surname

First Names

Address (inc postcode) 

Telephone

Fax

E-mail

CORRESPONDENT (i.e. Person for communications if different from above)

Title

Surname

First Names

Address (inc postcode) 

Telephone

Fax

E-mail

DESCRIPTION OF PARISH

POPULATION OF PARISH

NUMBER ON ELECTORAL ROLL

COUNTY

DIOCESE

BRIEF SUMMARY OF GRANT REQUIREMENT

Provide conservation report attached

ESTIMATED COST OF PROJECT

£

Provide quotation attached

OTHER GRANTS OBTAINED OR APPLIED FOR

OTHER CONSERVATION PROJECTS IN PROGRESS

 

SIGNED

 

 

............................................................................

 

DATE

NAME  OF SIGNATORY

POSITION OF SIGNATORY

This form should be returned to:

H Martin Stuchfield, F.S.A., 

Hon Conservation Officer, Monumental Brass Society, 

Lowe Hill House, 

Stratford St Mary, 

Suffolk CO7 6JX

Registered Charity No. 214336

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Copyright © 2002 Monumental Brass Society (MBS)

Page last updated 30 June 2009