LICHFIELD THEOLOGICAL COLLEGE TRUST

Application for grant from 
the Approved and Accredited Academic Course Fees Fund
Please note: Trustees require supporting paperwork, including either a breakdown of any budget figure provided, or the name of any institution and course for which help with fees is requested.  Forms must be counter-signed by the appropriate person.

Name:							Tel No:

Address:

Email address

Licensed minister in the diocese of            _____________________________

As (post or category of ministry)		____________________________

Title of degree/course				____________________________

Name of institution				____________________________

Please describe the course in less than 100 words, indicating dates of initiation and completion.
Note that repeat applications may be made for up to three years.  A maximum grant of £400 is normal.  

Total Fees:					

Proportion applied for:

Other funding is being sought from:

Signed:					Countersigned:

						Member of Bishop’s staff or Director of Training

Please return to:  The Secretary to the Theological College Trustees
	                c/o Mrs Jean Overton, The Diocesan Office, St Mary’s House, The Close, 
		    LICHFIELD, WS13 7LD   Not later than 30 April or 30 September in the year