ELECTRONIC APPLICATION FORM

SIR PHILIP RECKITT EDUCATIONAL TRUST Registered Charity Number 529777
The Trustees, Sir Philip Reckitt Educational Trust c/o Mrs Julie Pickering, 99 Yarmouth Road, Ellingham, Bungay, NR35 2PH Tel/Fax 01 508 518115 Email applications to spretrust@googlemail.com website www.spret.org
APPLICATION FORM
PERSONAL DETAILS * Required fields that must be filled in
*Name:	*Date of birth (dd/mm/yy):

*Telephone:	*Email:

*Address: (first two lines minimum please)	Term address (if applicable):
*Postcode:	Postcode:
School/College/Place of business:	Name of Principal/Employer:

*Reference:
(Please indicate how your reference from your Head Teacher, Principal or Employer etc. will be submitted)
By Post By e-mail attachment By Direct e-mail message Please indicate by placing an X in the appropriate box
EDUCATIONAL TRAVEL OR PROJECT DETAILS
Briefly outline the nature of your project:
please see †disclaimer
Does this project have any relevance to your present education/employment:

Date of travel:	Duration:

Cost of visit:
(a) Travel:	(b) Maintenance:
Have you applied to any other organisation for assistance:
no yes
If so with what result?:

ABOUT THE TRUST
Have you previously received an award from the Trust:
no yes
If yes, state year and amount:
Year:	Amount:
How did you hear about the Trust:

†Disclaimer:
The Trust accepts no responsibility for any loss, damage or injuries which arise directly or indirectly from activities undertaken by you as a result of a grant given by the Trust. All recipients of grants are strongly recommended to ensure they have appropriate insurance cover for activities covered by the grant and to take professional advice as to cover they should obtain.
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SIR PHILIP RECKITT EDUCATIONAL TRUST EDUCATIONAL TRAVEL GRANTS The Trust was established in 1944 by the late Sir Philip Reckitt. Sir Philip was a former chairman of Reckitt and Sons Limited and he had always taken a great interest in educational matters particularly for the benefit the Company’s employees. The Trust is a registered charity (Registered Number 529777).