SIR THOMAS MIDDLECOTT'S
EXHIBITION FOUNDATION
Charity Registration No. 527283
APPLICATION for GRANT
Name ...................................................................................
Address ....................................................................................................................................................................................
Post Code .........................................................
Telephone No. .......................................................... Email address ...........................................................................................
Date of Birth.............................................................. Primary School attended ................................................................................................
From (Date) ............................... To (Date) .............................................. (You need to have attended for at least 2 years in order to qualify for a grant)
To help us verify this information please give your class Teacher's name: ....................................................................................
Name and Address of the University, College or other place of further education that you are/will be attending:
..................................................................................................................................................................................................................................................
Name of Course: .......................................................................................................................................................................................................................
Start date and Length of Course. .....................................................................................................................................................................
FOR UNIVERSITY STUDENTS PLEASE ENCLOSE A COPY OF PROOF OF STUDENT STATUS
FOR OTHER COURSES PLEASE ENCLOSE A COPY OF YOUR CLASS SCHEDULE OR OTHER DOCUMENT CONFIRMING YOUR COURSE OF STUDY.
Bank details (Grants will be paid by BACS).
Bank name .............................................................
Name on Account ..........................................................................
Sort Code ........................................... Account number ............................................................
Signed ................................................................................................... Date ...................................................
Please post this form and your proof of student status to:
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