The Daphne Bullard Award

Application Please read the Application Guidance notes 1. The Applicant Name of applicant’s organisation ………………………………………………………………………………….. Name of applicant …………………………………………………………………………. Current position ….………………………………………………………………………. Work address ………………………………………………………………………………. ………………………………………………………………………………………………….. ………………………………………………………………………………………………….. Postcode …………………………. Day-time Tel. No. ………………………………… Contact address (if different from above) ……………………………………………. ………………………………………………………………………………………………….. ……………………………………………………………………………………………………………… Postcode ……………………………… Email address: …………………………… ACE Accredited Museum Number or status of Museum (provisional Accreditation. Working towards Accreditation or non Accredited) ………………………………………………………………………………………………… Organisation annual expenditure (turnover) ………………….…………………………………………………………………………….… 2. Project Summary of project for which award is sought ……………………………………………………….………………………………………. ………………………………………………………………………………………………….. ………………………………………………………………………………………………….. ………………………………………………………………………………………………….. ………………………………………………………………………………………………… Brief description of work to be funded by the award ...……………………………………………………………………………. ………………………………………………………………………………………………….. ………………………………………………………………………………………………….. ………………………………………………………………………………………………….. Breakdown of likely costs involved Please indicate amount sought, and how it is to be applied, the proportion of total project costs represented and amount raised to date, including other funding sources ………………………………………………………………………………………………… ………………………………………………………………………………………………… ………………………………………………………………………………………………… Anticipated date of completion of work ………………………………………………………… Name of conservator/conservation firm (where applicable) The conservator does not need to be ‘in-house’’ ……………………………………………………………………………………………….. ………………………………………………………………………………………………… 3. Supporting statement Please attach a statement, of no more than 300 words, in support of the application. This should be by a senior member of staff with responsibility for the work. (see 5) 4. Declaration I agree to provide a written report of 500-1000 words on completion of the work as required, should this application be successful. Signed …………………………………………… Date ………………………………… Send applications to the Secretary at bullard.callow.hammond.assoc@gmail.com Applications are accepted at any time 5. Proposer Name ………………………………………………………………………………………. Post …………………………………………………………………………………………. I have personal knowledge of the project for which this application is being submitted and I support this application for a grant by the trustees. I confirm that the project will be completed by the date given in section 2 and that it is included in the organisation’s forward plan. Signed ……………………………………. Date ………………………………………… N.B. A short supporting statement, of not more than 300 words, outlining the value of this project or its significance to the proposer’s museum or organisation will assist the trustees when considering the application

Email