Please note that an asterik (*) denotes a required field

Your personal details:

*Please enter your name:

*Please enter your e-mail address:

*Please enter your Club/Society/Charity name:

*Please enter your telephone no:

*Please enter your address:

Project plan. Please give us a short description of the event you wish to hold, including relevant details such as date, location etc

What will the money raised from the event go towards?

How would you like to see S4C supporting the event?

Are you a registered charity?

If yes, please give us your charity number

1. It is hereby agreed that all funds raised with assistance provided by S4C will be used only for the purposes stated in this application form.

2. I confirm that I have the authority to bind the above organisation to the terms of clause 1 above and if I do not then I will be personally legally bound to ensure that a sum of money equivalent to the funds raised with the assistance of S4C for the organisation is paid to them to be used for the purpose stated above.