[wp-svg-icons custom_icon=”leaf-wp-svg-custom-ms” wrap=”i”]Apply – Step 4 of 4 Northern Ireland Act 1998, Section 75 questionnaire. This section may take 2-4 mins to complete The information you provide will NOT be used to assess your group’s eligibility for funding. It is for monitoring purposes only to enable us to improve our service to the wider community. Please tick all relevant boxes that might apply in each grouping. This project will benefit: 22. Persons of different religious belief: (optional) ProtestantCatholicBuddhistHinduIslam/MuslimJewishSikhOtherMixed religious beliefs focus 23. Persons of different political opinion: (optional) UnionistNationalistOther 24. Persons of different racial groups: (optional) Black AfricanBlack CaribbeanMixed Ethnic GroupOther Ethnic GroupChineseWhiteIrish TravellerIndianPakistaniBangladeshiIrish NationalityBritish Nationality 25. Persons of different age: (required) Under 18Between 18 – 25Between 26 – 5960 and over 26. Persons of different marital status: (optional) MarriedUnmarriedDivorced/SeparatedWidowed 27. Persons of different sexual orientation: (optional) GayBisexualLesbianHeterosexual 28. Male or Female: (required) MaleFemaleTransgendered people 29. Persons with a disability or persons without: (optional) Persons with a disabilityPersons without a disability 30. Persons who care for others: (optional)Care of a childCare of a dependent elderly personCare of a person with incapacitating disabilityWithout dependents All contact details submitted to us will be held on a database. We take your privacy very seriously and will only use your personal information to administer the grant application process and to contact you with information relating to matters that may be of interest to you. Once you hit the ’Send’ button you will no longer be able to make any further amendments to your application. We advise that you read over your application thoroughly before sending. Once we receive your completed application form we will let you know and email you a copy of your completed form. Grant decisions are normally made on a monthly basis so we will let you know within 4 weeks, if your application has been successful. Declaration, I hereby confirm that the information provided in this application form is accurate and truthful to the best of my knowledge. I have not knowingly withheld any information that could reasonably be considered relevant to this application. By ticking this box, you confirm that you accept and understand the agreement and consent to our privacy policy in full. (required) Your Name: Date Go Back OR [multistep "4-4"] Δ