Social Club Bursary Form

We have three bursary places available for Social Club. These spaces will be provide a space in each session from April up until December.
Please fill in the following application and we will be in touch within 10 days.
In order for us to review your current situation as impartially as possible, please complete this form and provide details of your current situation with as much detail as possible.   Due to the confidential nature of this document, the information you provide on this form is kept on file for one year only.  
Name(Required)
 
 
 
 
Home Address(Required)
 
We don't want to be nosey, but we do want to make sure that these places are going to people who will directly benefit. We won't ask for the documents, but it would be useful to know if you receive any of the following(Required)
 
Can you attend every Thursday Senior Social Club Session, 12-2pm from 18 Apr – 19 Dec
Other than an illness or doctors appointments etc.
 
 
I declare that the information I have provided on this form is true and correct to the best of my knowledge. I understand that purposefully giving false information will automatically disqualify me for any financial assistance from the Mercury Theatre, I also understand that completion of this application does not guarantee that I will receive the financial support that I have applied for. I understand that all applications are processed subject to availability of funds and eligibility criteria.(Required)