Widening Participation Impact Pot Application Form Title of Proposed Project: Name of Project Leader: Email Address of Project Leader: Telephone Number of Project Leader: Amount of Funding Request: Please return your completed application form to Will Cooling at outreach@le.ac.uk by 10am on Monday 11th May 2015. When completing this application form please note that when deciding whether to fund your project, the Widening Participation Impact Pot Management Group will also consider the extent to which: a. The project will raise the profile of the University of Leicester amongst underrepresented groups b. The project will be an efficient use of resources Additionally all projects funded by the Widening Participation Impact Pot will be centrally evaluated. As will be specified by the Widening Participation Impact Pot Management Group after funding has been awarded, project leaders will be required to provide access and information to facilitate this evaluation. Q1. Please outline which demographic group(s) your project is aimed at and how you will ensure it effectively targets them. Please note that these must include at least one of the following groups: a. b. c. d. e. f. Living in a low participation neighbourhood (POLAR3 Quintiles 1 & 2) Coming from a lower socio-economic household (NS-SEC 4-8) Being the first in the family to come from higher education Self-defining as disabled Being a mature learner Those who have experienced educational disadvantage due to self-defining as Lesbian, Gay, Bisexual or Trans g. Belonging to an underrepresented ethnic minority h. Belonging to an underrepresented gender Please Write Answer Here If you have any questions about the Widening Participation Impact Pot or need any assistance with your application please contact Will Cooling (wic1@le.ac.uk) or Professor Emma Smith (es228@le.ac.uk). Q2. Please outline the socio-economic or educational disadvantage(s) that affects your target group(s) which you are trying to address in this project. Please Write Answer Here Q3. Please outline how your proposed project will address the educational disadvantages that you identified in your previous answer. This could include: a. Encouraging progression to higher education from underrepresented groups b. Improving student retention and academic performance amongst students from underrepresented groups c. Improving progression amongst students from underrepresented groups to graduate employment or postgraduate education d. Informing the University of Leicester’s approach to widening participation through research Please write answer here Q4. Please outline the three main things that your project will have achieved if it is successful Please write answer here Q5. Please attach a draft plan for your proposed project using the template provided. Please provide as much detail as possible. This should include: Timelines for proposed activities How you propose to use the budget that you are requesting The full project team (please specify if participation is linked to funding from the Widening Participation Impact Pot) Key Performance Indicators i.e. number of events, number of participants, etc Suggestions as to how the project may be evaluated afterwards Q6. Is there anything else you would like us to know when considering your application? Please Write Answer Here If you have any questions about the Widening Participation Impact Pot or need any assistance with your application please contact Will Cooling (wic1@le.ac.uk) or Professor Emma Smith (es228@le.ac.uk).