Your project title*:

Group/organisation*: (if applicable)

Address:

Postcode:

Start date for project*: (if applicable)

When/how regularly does the project group meet: (if relevant)

Title: - - Please Select - - Mr Mrs Miss Ms

First Name*:

Surname Name*:

Address:

Postcode:

Daytime Number*:

Evening Number*:

Mobile Number:

Email Address*:

Do all volunteers or staff working with young people for your organisation/project have the appropriate Criminal Record Bureau (CRB) checks completed?:

Briefly outline the details of your project :

Describe how High Sheriff Youth Awards funding will support your project :

Who will benefit from the grant?: - - Please Select - - Local young people Local community Vulnerable young people Other (please specify)

If other please specify:

What age group will the project work with?:

How many young people will benefit?:

If you would like to provide more details to support your application please include them with this submission and email as an attachment to applications@surreyhighsheriff.org.

(Please provide information to show how your project works within one, or more, of our objectives)

Enjoy and achieve:
Find out more...

• Give young people places to go and things to do

Stay Safe:
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• Show young people how to prevent and reduce crime
• Tackle bad behaviour in the community
• Make everyone, whatever age or cultural background, feel safer in the local area
• Explore how crime affects victims and communities

Make a positive contribution:
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• Persuade others to care about the area around them
• Encourage respect for other people's property

Total cost of your project?:

What financial support do you want from the High Sheriff Youth Awards?:

Breakdown of project costs?:

Are you asking for other funding?:
(Give details)

Have the young people involved organised their own fundraising activities?:
(Give details)

Are funds required urgently?: - - Please Select - - Yes No

(Please provide dates if appropriate):

HSYA wants to know how every project that receives an award uses our funding. Submitting this application means you agree to take part in this evaluation process with a HSYA assessor. Visit our website at www.surreyhighsheriff.org to see the questions we'll need you to answer after one year.