THE McKENZIE TRUST

Application Form

Please fill in this form using a typewriter or obtain the document from the download tab on the left of this frame, and complete it using WORD or OPEN OFFICE (both formats are available on the download page).

If there is insufficient space for what you want to say then by all means refer to an appendix or set of appendices. If sections are covered by a business plan then annotate this form accordingly.

Name.................................................................

Company (if exists)..........……….... or proposed name ...........………………………………….....

Address for correspondence................................................................................................................

Contact telephone............Fax.............Email...................

How long have you resided on Island..................................

What is your current occupation......................................

How long have you occupied this position.............................

How much do you need.................................................

How much are you able to obtain from other sources...................

Do you understand the conditions.....................................

Do you accept the conditions in full.................................

When will you be available for interview.............................

Declaration:

I have read and accept the conditions set out in the Trust Leaflet and have completed this form accurately and set out below full details of my project in such a manner as to disclose all material information which will help the Trustees assess whether to offer assistance through a capital investment.

Signature..................... Date.................

Now continue on as many sheets as you wish with a full description of the project, its aspirations, its drawbacks and the downside potential. Cover the opposition, how the project will be marketed and what the target profits are and when. You may use any method which suits you and if you wish to create a presentation such as a Powerpoint or OpenOffice computer set, then please do so and submit it on a virus checked CD or floppy disk. Send all communications to c/o 5 The Fountains, Ballure Promenade, Ramsey, Isle of Man.

Good Luck!