Group Name

Main Contact Name

Correspondence Address

Postcode

Email

Telephone

Additional Contact

Email

Telephone

Website

Facebook

Charity Registration Number (if applicable)

Section 2: Eligibility Checklist Section 2: Eligibility Checklist Our organisation is not-for-profit and operates on a voluntary or community basis. We are based within or operate primarily in Causeway Coast & Glens Borough Council, Mid & East Antrim, or Antrim & Newtownabbey. We support grassroots community development and are committed to improving the lives of local people. We do not promote any activity that is party political in nature. Our activities and communications are non-discriminatory, and we do not promote or tolerate discrimination based on religion, race, gender, colour, disability, or any protected characteristic.

Brief description of your organisation’s purpose and main activities (max 100 words)

Target groups or communities you support (e.g. youth, older people, ethnic minorities, carers)

Do you have a governing document e.g. Constitution Do you have a governing document e.g. Constitution Yes No

Are you formally constituted Are you formally constituted Yes No

Are you a registered charity Are you a registered charity Yes No

Name

Role

Date