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Please note any fields marked with an * are required.
*1. Customer name
*Name of LiveWest colleague supporting this application
First name of LiveWest colleague supporting this application
Last name of LiveWest colleague supporting this application
*2. Have you previously applied for LiveWest funding?
Date if previously applied for LiveWest funding
If you have previously applied for LiveWest funding, what was the outcome?
*3. Amount applied for: £
*If your application is successful we will normally need to send payment by cheque. Please state who the cheque should be made payable to. If there is a problem with being paid by cheque, please explain here.
*4. Please explain what the funding will be used for.
*5. When do you propose to use the funding, for example course start date?
*6. What difference will the money make to you and your future for example how the training course enable you to find employment or how will you sustain a new business when the grant funding is spent?
*7. Please provide details of costings. Please note that if your application is successful LiveWest will require copies of receipts in relation to these costs. LiveWest will award a maximum of £250 for laptops and software.
*Are there any other funding contributions? £
8. Please provide details of the course or grant provider (name of course, dates and contact information for invoicing).
*9. What steps have you taken to achieve your goals outside of LiveWest funding? Have you attempted to gain funding from other sources. If so where and what was the result? Have you undertaken other training or related courses? Please explain any related activity or preparatory work.
10. Please provide any additional information to support your application. For business start ups please include details of turnover, projections and market research.
*11. Please state which Local Authority area you live in
*12. What is your current employment status?
*13. Applicant monthly wages £
Partner monthly wages (if applicable) £
*Universal Credit received per month £
*ESA received per month £
*JSA received per month £
*Child Tax Credit received per month £
*Working Tax Credit received per month £
*DLA/AA/PIP received per month £
*Child Benefit received per month £
*Housing Benefit received per month £
*Income from non-dependents received per month £
*Other income received per month £
*Total income received per month £
*Rent/Mortgage cost per month £
*Council Tax cost per month £
*Water cost per month £
*Gas cost per month £
*Electricity cost per month £
*TV Licence cost per month £
*Housekeeping cost per month £
*TV/phone cost per month £
Any other monthly expenditure costs? £
*Total monthly expenditure costs £
14. LiveWest colleague comments. Please provide any further information to support the application.
*Signature: I confirm that I have read and understood the information provided within the guidance notes and agree to the terms and conditions. The information I have supplied on this form is true and accurate to the best of my knowledge and correct at the time of submission. i authorise LiveWest to process the information in this application as described. Please note that a decision can take up to four weeks from the deadline date of the first Tuesday of each month. LiveWest is subject to the requirements of the General Data Protection Regulation, please see our website for our current Privacy notice. By signing this form you agree to the following: We will use this application form and the other information you give us for the following purposes only: To decide whether to support your activity or project with LiveWest funding. To hold in our database and use statistical purposes and future monitoring of the project. By writing your name on this form and submitting it to Livewest, we can take this as consent for us to hold the data provided and use it for the purpose it was given. LiveWest reserve the right to withdraw any application. In submitting this application you confirm that, to the best of your knowledge, the information provided on this form is correct and you confirm that any grant awarded will be used exclusively for the purposes described.
*Please tick to confirm you have read our Data Protection Statement.
Please attach any supporting evidence to clarify costs
One file only.
16 MB limit.
Allowed types: gif jpg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit svg tar zip.
*How did you hear about LiveWest grants?
Word of mouth
Find out more here