Name and address of your group/organisation (& contact name & address ifdifferent): _ _. {(::-crf'-i rdc-T'C f< AN' FOR D L f)}) I/;;-$ C; f<....c.yUP A- ~ . /-,[/1 c-;~f.1

(~ ~£R t~eL t:' y AV£NU~C QAN~DP-s:> Ml'vJl)l ~-l4 ~LA. Tel: o~zog89709b

Date organisation started: .r-r~~L'l ,Nf~12T7~

Is your organisation a registered charity?

Do you have a constitution?If applying for the first time, enclose copy constitution

Y;ۤ; No~

Yes/ ~~

Please specify only one criteria category under which application submitted, (Referto the enclosed list of qualifying criteria): rp1<-D:3g-c-I A- J-.-J D evL?1JJ$F6>R bi;:J?£~ 'I t9UN 0;. (/e-DPLB ~.-rc--.

/ -

Proposed date(s) of the project/event: L.AS T

J7PTyynB~1Z ;Le II

I Please indicate which area the proposed project/event will take place: (See the attached I (H 175 jt9N ~ C--~ A-N FDAS> ;&iL./3)1- Cz:rrnf1')r77oz;!

map for the Committee Boundaries). Tick the appropriate boxA - West Afea-eortilt1itt~e 0 0 - Islewert:h-&i3rerlffDretArea CommitteeB - Gentral HOUH&lew-Ar:ea..QQmmitte~ 0 E~swick1\lea CornmitreeCHeston & Cranford Area Committee [;Y-Approximately how many people will benefit from this project:

?;0

Please give a full description of the proposed event/project:(continue' on a separate sheet if necessary)

."--10

/J?e-

Sa-A-

~C~*N(S£ :Y~'tc)LD l-A''P) FS "70.~"' i~ g-~-

How do you know there is a need for this project? '0 U R. 1j-:) c;...-r .H L::;;"-

~lZ"c;:;u ~A' R yY) £PJ/'H ~ A L )'V11:7'&'T /1l- L 7)1 ~J11Em f3 ~_ L -A~ J e'S iZ"")<.f'12- -C5SE!:2J/h In fJ... DES 1 f!... L-

70 GO bUt AkD EAI)b °JH0YH-e:DU/f3J 'f~T~ f'Hel2.2

Please state the detailed timetable for planning the proposed project/event:"TJ1e -tR.l P tv 1L l 5;;4 ROT /,Lt/;-r l:T ynb"f>..J..! (N <7<..

., f( ~ /?-y ._/ It~" __17'1rrt? 1--I?" P ~). A I !.~s T/N A~i 'Drt+~ J-f. C. 0 M t-:: 4C ~ " J) f;::- .t~YZ::-)--t/».cJ4

Are there any particular sections of the community who will benefit?;11e (9 i~17£f2-- 1-/1» j ;:::-5 J<::J<- oM -) J-1 &

frl g)11 ~ t;~(J(f,.

I Will you market this project?

Who (other than the contact name) will work on the proposed project?[:;Xf7C-U-JlVe L~PJr TT2h-M~m~~

Do you have any other sources of income to fund this project?

If Yes, please give details:

}~No

Income Source £------------- ----------Income Source £ _

Income Source £ _

What will be the total cost of this project?£ 7 '-ID <;:Z- o{:/

Please give a detailed breakdown of the costs for this project.

ITEM

(eg. Printing/'" () ,~kD fr t-H H{/,-[.:..

&- cAZ L tJ)./ GJi

COST£100)

50 ~ :::z-- 6Db 1 '7 S-=-

Do you currently receive any funding from Hounslow councilor external sources?~No

,--£ j DD ;:;::2':-

Signed /J ·d~', gaVI.ofh ~

Print Name ---BtvttliR _llT k:Ytue 'Position C;PC- /?.tiL).,ryft zo~ 7

Date _

t!Jq N..P/-i /J LJ ~ 1

Please return this form to:Community Partnerships UnitCommunity ServicesLondon Borough of HounslowCivic CentreLampton RoadHounslow TW3 4DN