Small Grant Claim Form

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Use this form if you wish to draw down funds from an already approved grant or if you are applying for a small grant of less than £5,000 from a designated fund.

Please Note: For procurement of goods/services or equipment: supplier quotes must be provided. Please also ensure that the supplier is on the Trust Oracle system prior to submitting your application. 

Before confirming your submission, please save a copy of your application by selecting the Print option and choosing to save a copy as a PDF. 
The form includes the following:

Content of application – additionality: Please note the Charity will not pay for any work which is considered to be the core normal function of the NHS.

FT approval: Applications must be supported and authorised by the Fund Advisor prior to submission.

Additional approvals: All equipment requests should seek approvals from relevant departments e.g., Estates to ensure adherence to the FT’s procedures and/or to ensure compatibility with existing equipment, on-going maintenance, and adherence to the Trusts standards of care. Please speak to your service manager (otherwise General Manager) about getting consent and approval.

Supporting documents and clarification: In some cases supporting documentation is mandatory. Please do not send any supporting documentation via email:

Reimbursement: Receipts must be provided and can be photographed/ scanned and attached to your application.

For Invoice payments: a copy of the invoice must be provided.

The Charity may come back to you to ask for more clarification on information.

Process for Charity approval: Following approval of your application by the Trust the Charity will review and may come back to you to ask for more clarification on information. We aim to process small grant applications within 10 days.

Submission: You will be asked to review your application prior to submission.
All questions with a red Asterisk * are mandatory. If left incomplete you will be prompted at the Review stage to go back and complete. 

Help and Support:
 Please contact with any questions.

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Applicant Details

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Small Grant Details
Please enter details of your designated fund below. If you're not sure of the name or number of your designated fund, please click here to see a full list.
Please enter your grant reference below. This can be found on your grant agreement letter and contains your surname and designated fund number.

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Attendee Details

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Item being procured
Please Note: all items must be available to procure through the Trust's procurement system. Please check in advance of submitting an application and get in touch with the Charity Finance team at if you need to discuss alternative sourcing.
Procurement/Raise an Order Only


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Delivery Details

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Bank Details
Please ensure you check the bank details submitted are correct as the Charity is not able to validate them prior to payment. Your bank details will not be shared with anyone other than the Charity Finance team in order to process your claim.
Reimbursement and Invoice Payment Only
If you are requesting a reimbursement please add the claimant name in the field below. If you are requesting payment of an invoice please enter the supplier name.

Family Member Details
Make payment to the following recipient (Supplier, Staff Member or Family Member Name )


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Applicant Declaration

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If this application is coming out of a designated fund, we require all applications to be supported by the fund advisor. The list of fund advisors can be found here. Please ensure you speak to the fund advisor to get support for your application prior to submission. The person named below will be emailed a copy of this form and asked to confirm their authorisation for it through an online process. Please ensure you provide accurate details and you may like to inform them about this process as the Charity will not be able to process your application without these authorisations.
Fund Advisor Approval

IMPORTANT: In the next screen you will be able to save a PDF copy of your application by clicking Print this page and from the Destination drop down select Save as PDF.