Town Centre Recovery Fund Application Form

Please note, the January reopening of the grant scheme is only for applications up to a maximum of £5,000 due to low funding availability. Please do not apply for a higher amount. Thank you

Business name

Please complete all sections as necessary.

In order to assist in the completion of this form, there is an expectation that the applicant will refer to the following supporting documents:

The Town Centre Recovery Fund – Guidance document
The ‘Stapleford Town Deal Town Investment Plan (TIP)’–in order to demonstrate where proposals within any application, provide strategic alignment to the TIP, contribute towards achieving the core vision for Stapleford and any targets.
These are both available at www.broxtowe.gov.uk/towncentrerecoveryfund

Any information provided within this form will be treated in the strictest confidence.

Please do not submit applications using this form for the recently announced Omicron Hospitality and Leisure Grant (OHLG), which is aimed at leisure and accommodation businesses, in response to the Omicron variant. That scheme is separate to the Town Centre Recovery Fund, which is part of the Stapleford Town Deal programme.

Contact Name

Position

Business Address

I confirm my business address is inside the Stapleford Town Centre boundary

Telephone

Mobile

E-mail

Website

Organisational Details (if applicable)

Business Name

Trading Name (if different)

Business Address (if different from above)

Business Rate Account Number

Brief Description of Businesses Activities

Legal Status of Your Business

Company Registration Number

Date of Incorporation

If Sole Trader or Partnership Unique Tax Reference Number (UTR)

Are you VAT Registered?

Please list details of other Directors/Partners included in the business

Name

Home Address

Name

Home Address

Have any of the above been subject of a bankruptcy order?

If yes. please provide details

Have any of the above outstanding County Court orders?

If yes. please provide details