This declaration should be signed by the applicant.
I am an authorised representative of -Name of charity
To the best of my knowledge the information provided on this application form is correct.
If BMCT agrees to make a grant this will be used exclusively for the purposes described. If a significant change
occurs that has a direct effect to the purpose of the funding I will inform BMCT immediately.
Please send the signed form including the following documents to the address below.
To: Mary Noble, Brian Murtagh Charitable Trust, 9 Hanson Drive, Fowey, Cornwall, PL23 1ET