Grant Application Form (MS Word Version)

advertisement
City of Edinburgh Small Steps Big Difference
Campaign Application for Funding
Funding is available on a small grant basis to develop and/or deliver activities / resources for women aged 20 -49 years which meet
the outcomes of the Small Steps Big Difference Campaign (see attached Guidance notes for criteria).
You are invited to apply for up to £4000 in partnership with another organisation
Grant funding 2012
Name of Project/Programme:
Name of Organisation requesting funding:
Name and Position of Contact Officer:
Address
Postcode:
Tel No:
Fax:
Email:
Please give a very brief description of your organisation’s main aims and activities: (150 words maximum)
YOUR PROGRAMME/PROJECT
Start date and end date of programme activities:
Amount requested:
Aims
(Please indicate how this grant will be used to meet
the outcomes of the Small Steps Big Difference
Campaign
Evidence of Need (please describe how you have
identified the need for this resource or initiative)
Sustainability – If appropriate, how you expect
the benefits of approach to be sustained after the
funding ends
Who are you working in partnership with to
deliver this project? Please provide a brief
description of the organisation’s main aims and
objectives. (150 words maximum)
Have you obtained any consents, permissions
or insurance necessary to carry out your
proposal? Please tick relevant option
(We may ask you for evidence of this)
Yes
No
Not necessary
Budget - How much will the programme/project cost in total; and where will any additional funding (over and above that
requested from the Small Steps Campaign) come from?
Expenditure
Item e.g. staff time, other resources required.
Estimated cost
Income
Sources of funding
Amount £
Activities, Outputs, Outcomes
Please complete this template (using the guidance re outcomes within briefing)
Objective and
Activity/Action Timescale
Resources
Outputs
Target
required
(including target
Group(s) or
numbers of
Area(s)
service users)
What bank account will you pay your grant into if your application is successful?
Outcomes
(what changes
do you expect
to see, and how
many
beneficiaries
will experience
this?)
How you will
measure the
impact of your
work
(be clear about
how you intend
to evaluate your
work)
Name of bank
Bank address
Account name
Bank sort code
Account number
If you are applying on behalf of a voluntary organisation, please make sure Please tick if
that the following documents have been included with this application:
attached
Constitution or Memorandum and Articles of Association, Trust Deeds of your
particular organisation
Most recent annual (audited) accounts. Where your organisation is newly
constituted, a most recent bank statement will suffice.
DECLARATION
All applications must be signed by two people who are recognised as representatives of your partnership. For voluntary
organisations, one of these people must be a board/management committee member.
You are being asked to declare that;

To the best of your knowledge, that the information contained in this application and any accompanying attachments is
accurate.
Date……………………………………………
Signature………………………………………
Position…………………………………………
Name……………………………………………
Signature………………………………………
Date……………………………………………
Name…………………………………………..
Position…………………………………………
FOR INFORMATION: EXPLANATION OF TERMS USED
Appendix 1
Aim: what the project is trying to achieve overall
Activity: what you will do
Timescale: when it will be done by
Resources: funding, staff time, other resources required. If staff time is the main resource please indicate the approximate
proportion of the person’s time to be devoted to this activity.
Output: to include, for example, how many times the activity will run and number of participants in the activity
Outcome: the expected change or impact (usually on the participants) as a result of the activity e.g. improved confidence,
knowledge
Evaluation measure: how you will measure the anticipated outcomes e.g. post course evaluation forms etc
Download