SPECIAL BENEFIT GRANT APLICATION Form can be filled out on your computer. Use tab to move between fields. All fields expand as you type.
APPLICANT INFORMATION
Name	Position
Phone	E-mail Address
orGANISATION
Organisation Name
Address
Roll of Qualifying Students
payee details for cheque.
items requested and costs
full details of application and educational outcomes
Disclaimer and Signature
I also certify that my answers are true and complete to the best of my knowledge.
Signature	Date
Special Benefit Notes
Please note the following before completion of the form. ELIGIBILITY: This funding facility is open to Trinity Primary, Valley Road Primary, Badgemore Primary and Sacred Heart RC Primary Schools. Due to our constitution, Gillotts School was not eligible for Section 28(2) special benefits after it changed to Gillotts Academy. However, it is funded the equivalent Special Benefit amount under a Section 28(4) grant and can use this form to apply. Nettlebed Primary can only apply for those students who are Bix & Assendon residents. Crazies Hill Primary School can only apply for those students who are Remenham residents. Yearly Section 28(2) Special Benefit funds are divided by total student roll. The trustees may occasionally change the multiplier to address a severe problem at a particular school. Henley College can apply for Special Benefits for those pupils who have spent two years at a qualifying educational establishment. (Trinity Primary, Valley Road Primary, Badgemore Primary, Sacred Heart RC Primary Schools and Gillotts Academy.) Special Benefit funding cannot be used for: -repair/maintenance of school infrastructure, training and salaries of staff.

Clerk to the Trustees Mrs Claire Brown Syringa Cottage Horsepond Road Gallowstree Common Reading, Oxon, RG4 9BP Tel: - 01189724575 Email:-clerk@henleyeducationaltrust.com www.henleyeducationaltrust.com