ASHBOURNE HISTORY FUND APPLICATION FORM

Full Name

Address Line 1

Address Line 2

Address Line 3

Post Code

If correspondence address is different please provide details .

Correspondence Address Details

Telephone number: Landline

Telephone number: Mobile

Email address

Title of proposed publication

Background and contents of the proposed publication

More detail or a draft text can be attached to this form.

Proposed format, number of pages and selling price.

How do you intend to have the publication printed and marketed?

How much are you asking for from the Fund?

We typically give grants of up to £250 for a small publication but will consider making a larger grant if appropriate.

Ashbourne History Fund Application Form