SIR THOMAS MIDDLECOTT'S

EXHIBITION FOUNDATION

Charity Registration No. 527283

APPLICATION for GRANT

Name

Address

Date of Birth

Telephone Number

Primary school at which you were at for at least two years to qualify for a grant. .......................................................................

From (Date) ............................... To (Date) ..............................................

To help us verify this information please give your class Teacher's name: ....................................................................................

Please give the name and address of the University or other place of further education at which you will/are attending:

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

Name of Course:

Start date and Length of Course.

 

Signed ...................................................................................................

Date ...................................................

Please post this form to:

Frank J. Wilson,
57A Bourne Road,
SPALDING,
Lincs. PE11 1JR.
U.K.

 

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