empowering the severely brain injured and their families via support, understanding and a network of care

Equipment Grant Scheme

Application form for Institutions

Declaration

I confirm that the contents of this application and accompanying documents are true to the best of my knowledge and belief. I understand and agree that:

(i) I may be required to produce upon request documentary evidence of expenditure for which a grant is sought;(ii) I may be required to repay to Brain Injury is BIG any part or the whole of any grant made that is not utilised for the purpose for which a grant is sought;(iii) I will be required to repay to Brain Injury is BIG the whole of any grant paid and any reasonable costs of recovery following any application that is willfully or recklessly dishonest.

Signature

Please send completed application form to: Brain Injury is BIG grant scheme, Brain Injury is BIG, 182 Goldsworth Road, Woking, Surrey, GU21 6NF
All applications will be considered by the trustees of Brain Injury is BIG who have absolute discretion and whose decision shall be final. Where applicable payments will be made directly to the supplier.