The Society for the Relief of Poor Clergy

Grant Application

SRPC makes grants from its own funds and those of JFW Deacon’s Mabledon Charity (on behalf of the Church Pastoral Aid Society). Applications are welcomed from, or on behalf of, evangelical clergy or lay workers of the Church of England or the Church in Wales, the Church of Ireland and the Scottish Episcopal Church, who are in need or in circumstances of hardship. It is a condition of the trust that applicants must be of an evangelical conviction. For further information about the restrictions on grant-making, please refer to the website: srpc-aid.com/for Applicants.

PERSONAL DETAILS

    • Title:
    • Forename:
    • Surname:
    • Status:
    • Single Married Divorced Re-married Widowed
    • Parish/role:
    • Address:
    • Postcode:
    • Tel No:
    • Date of birth:
    • Email
    • Spouse's
       name:
    • Currently
       employed?
    • Profession:
    • Dependent
       children
    • Date(s) of
       birth:
    • Other
       dependents

      Please provide a brief summary regarding the particular need that has prompted you to make this application.

 

      Who would you like us to contact (name, email, phone, etc.) if we need further information to help us consider your application? We reserve the right to contact your Archdeacon.

INCOME

    • 1. Gross annual amount from all church sources (e.g. – Church Commissioners, Pensions Board, PCC, local church, mission agency, etc.)
    • £ 
    • 2. Annual amount from state benefits (e.g. - child benefits, family/tax credit, disability or carers’ allowance, etc.)
    • £ 
    • 3. Gross annual amounts from any other sources (e.g. - spouses’ earnings, interest on investments, rents, etc.)
    • £ 
    • TOTAL (1-3 above):
    • £ 

      Details of applications for grants from all other sources giving names and indications of likely outcomes.

EXPENDITURE

    • 1. Do you occupy the property in which you live free of rent, council tax, etc.?
    • 2. If you pay rent and Council tax how much do you pay per annum?
    • £ 
    • 3. Do you own or part own a property?
    • 4. If so, and you have a mortgage on it, how much is it per annum?
    • £ 
    • 5. If you are retired and occupy a Pensions Board CHARM Scheme property, what is the amount you pay to the Board if the property is mortgaged/shared ownership/rented (please indicate which)?
    • £ 
    • TOTAL (2, 4 & 5 above):
    • £ 

      Are you committed to other exceptional expenses? If so please state nature and amounts.

 

Bank details

If SRPC Trustees are able to make a grant in this instance it will be paid directly to your bank account.

Please supply the following details:

    • Your bank:
    • Bank sort code:
    • Account name:
    • Account number:

You can enter your bank details here with confidence as this is a secure server or https web page. Data is transmitted to our server using 2048bit data encryption meaning that your information cannot be read by anyone other than us. Please right click on the green padlock in the address bar for full information on our security certificate and validation.

Your journey of faith

    • Please briefly outline your journey to faith.

How did your hear about SRPC?

CONFIRMATION OF APPLICATION

The Trustees are obliged under the rules, and in accordance with the purpose of the funds, to restrict grants to those who identify themselves with the Evangelical tradition within the Church of England. Your signature will be taken as evidence that you understand this and confirm it as your position.

    • NAME:
    • DATE:

The Secretary, SRPC, c/o CPAS, Unit 3, Sovereign Court One, Sir William Lyons Road, University of Warwick Science Park, Coventry, CV4 7EZ Society for the Relief of Poor Clergy

Application Form – 2017