Application Form
Please download, complete and submit your application form electronically and email to careers@ncl.ac.uk.
Please type ‘Student Initiative Fund Application’ into the subject field of the email.
About you
Name:
________________________________________________
Student number:
________________________________________________
Degree programme:
________________________________________________
Stage or year of graduation:
________________________________________________
Email address:
________________________________________________
Contact telephone number
________________________________________________
The Alumni Association Student Initiative Fund only supports extra-curricular projects.
I confirm that I am not receiving academic credit for any part of this project:
Yes/No
About the project
Project name
________________________________________________
Expected project start date:
________________________________________________
Expected project completion date: _______________________________________________
Will other Newcastle University students be involved in the project?
If so, how many? ______________________
Yes/ No
Tell us about your project and why you are doing it
What do you expect the social, community or cultural impact of your project to be?
How will you know the project was a success?
How will you develop your skills and knowledge through this project?
Project management schedule (include start and completion dates and a list of all key
planning activities or milestones)
How will you raise awareness of your project? e.g. promotion and dissemination
Any additional information which may support your application
Have you applied for or received any other funding towards your project?
(If yes, please give details)
And finally, how did you hear about the Alumni Association Student Initiative Fund?
The Money Questions
Use this table to identify what you will spend money on. Please consider ALL aspects of the
project (e.g. insurances, materials, equipment, marketing/ promotional costs, transportation,
venue hire/ catering). (Double click in the worksheet to activate the embedded spreadsheet).
Please consider your project costs thoroughly as your budget is critical to the outcome of your
application (remember to include VAT where applicable).
Please also include any other expected income from your project or event (e.g., other grants or
support, ticket sales, conference registrations, sales, etc.).
Revenue for project (e.g.,
other grants or
sponsorships, ticket sales,
in-kind support)
What we will spend money on
(list ALL items below)
Expense description
Total Expense
Total Income
Amount
Income Description
Amount
£0.00
£0.00
£0.00
RISK ASSESSMENT RECORD
Assessment Ref:
Assessment Subject:
Assessment Date:
HAZARD
POTENTIAL
HARM TO
CONTROL
MEASURES
RISK
RATING
C
L
R
Sources of information for assessment:
Expected review dates:
Signed: _________________________________ (Project Co-ordinator)
Signed: _________________________________ (Appointed Safety Advisor)
Risk Ratings:
Likelihood
5 = Death
4 = Injury requiring hospitalisation
3 = Injury treatable on site
2 = Incident leading to slight shock
1 = Property damage
Review Comments:
Consequences
5 = Regular occurrence
4 = Likely
3 = Possible
2 = Remote possibility
1 = Unlikely to ever occur
FURTHER CONTROL MEASURES
Terms and Conditions
If approved I agree:

To regularly inform the Fund committee of progress and any changes that may affect the outcome of the project.

Any grant awarded will be used for the sole purpose of which it is intended.

To submit receipts and a project summary report no later than 4 weeks after completion of the project or by the date
agreed with the Fund committee.

To be liable for any monies unaccounted for and/ or to return the grant in full if the project is suspended.

That project images or materials may be used by Newcastle University for promotional purposes.

All promotional literature (fliers, brochures, posters, websites, etc.) must include the ncl+ logo and acknowledge the
Alumni Association Student Initiative Fund.

If asked, to speak to members of the Annual Fund phonathon team, the Alumni Association or other ncl+ partners about
my project and the support received from Fund partners.

My project will not bring Newcastle University into disrepute.

Newcastle University accepts no responsibility of liability for actions, purchases, bookings or rentals made in connection
with this funding.

To undertake and submit a full project risk assessment.

To provide evidence of necessary insurances and authorisations.

No commitment must be made to bookings or purchases before an offer of grant is received.

Grants not collected within six months of an award being made will be deemed to have expired.

Grants will be awarded at the discretion of the Funding Committee.

The Committee’s decision is final. There is no right of appeal.
I accept the terms and conditions of the grant and confirm that it will only be used for the purposes
approved.
For the Project:
Signed: _______________________________ Print Name: ___________________________
Date:
_______________________________
Staff Only:
Payment method: Cheque:
Transfer To:
Agreed Date for Financial Statement
and Report: ______________________
Statement and Report Checked and Attached: