1. Details of Applicant:

Title and name of Applicant:

Address of Applicant, including post code:

Telephone number:

Email address:

2. Description of Project:

Title of Project:

Description of purpose(s) of Project:

Details of proposed methodology:

Proposed timetable, including final publication:

3. Funding arrangements:

Total Project budget:

Amount requested from the Fund:

Particular purpose for which any allocation from the Fund would be used:

4. Other relevant and/or significant information:

5. References:

Please provide the names, addresses, telephone numbers and email addresses of 2 referees

Referee 1:

Referee 2:

6. Date of Submission: