Application For Non-Domestic Discretionary Rate Relief Name of Organisation: Required Account Number: Required Address of Property for which relief is sought: Required Postcode Lookup Please note: you will not be able to submit this form if this address is not within the City of Stoke-on-Trent The address you entered is not in Stoke-on-Trent. The city council can only deal with claims within the city of Stoke-on-Trent. Is the organisation a registered charity or Community Amateur Sports Club? Required Please select.. A registered charity Community Amateur Sports Club Other Charity Registration Number: Required CASC Registration Number: Required Other, please state Required What is the property used for? Required What are the objectives and activities of your organisation and how do they benefit the local community? Please give details below. Required 1000 characters limit Is the organisation affiliated to a local or national representative body? Please give details. Required Is membership to your organisation and use of the facilities open to all? Required Please select.. Yes No Please give details of any exclusions and the reasons for those exclusions. Required Does your organisation actively encourage membership from particular groups ? Required Please select.. Yes No (e.g. Young persons, ethnic minorities, the elderly, disabled persons, working parents) What methods do you employ to encourage use from these groups? Please give details. Required What percentage of your organisations membership or users come from Stoke-on-Trent or its surrounding area (up to 5 miles beyond Stoke-on-Trent boundary)? Required Please select.. < 29% 30 – 49% 50 - 69% 70% + The Council reserves the right to request further clarification of the information given. What are the membership fees and/or charges for use of the facilities? Please give details of all types of membership and/or fees for use of the facility and any concessions granted. Required Is the building used by the organisation, available for use by the Community or by other organisations? Required Please select.. Yes No Please give details of any other organisations using the building, the length of time used and the frequency of the use Required What education, training or coaching does your organisation provide to your members or users? Please give details. Required Does the organisation attract Grant aid or generate income through fund raising activities? Required Please select.. Yes No Please give details. Required