To apply to the Co-operative Action Fund please complete the form below. Click here to find out more about the Fund before applying. Name* First Last Email* Phone*Where do you live*---Please Select---East of EnglandEast MidlandsLondonNorthern IrelandNorth East & North CumbriaNorth West EnglandScotlandSouth East EnglandSouth West EnglandWalesWest MidlandsYorkshire & the HumberHow much are you applying for?*Aims & Objectives:*Please tell us what you hope your project will achieve and how you will measure if it's successful.About your project:*Please give a breakdown of how you're project will work. You may want to mention things like how you plan to spend the money, the timings for your project and any local groups you are working with (e.g. your Co-op Party branch, a co-op society or community group).Additional Support:Please tell us about any additional support you may need to help deliver this project. This iframe contains the logic required to handle Ajax powered Gravity Forms.