Public Health small grants application form

Name of grant:

About you

Name of applicant

First

Last

Applicant type

Individual

Organisation

Partnership

Email address

Telephone number

About your organisation

If you are an organisation—or the lead organisation for a partnership—please tell us

Organisation legal name

Organisation address

Website (if applicable)

Are you based in the local area covered by this grant?

Yes

Do you have a bank or building society account in the organisation’s name?

Yes

Legal status of your organisation (if other, please state):

Limited company

Community Interest Company (CIC)

Charitable incorporated organisation (CIO)

Charitable company or trusts registered with the Charity Commision

Limited liability partnerships registered at Companies House

Community benefit and co-operative society

Other…

Company registration number (if applicable):

Charity registration number (if applicable):

VAT registration number (if applicable):

Year the organisation was formed:

Organisation turnover (last full financial year):

About your project

Please answer the following questions using the prompts (please note your answers do not need to be limited to the prompts). You may use up to 1,000 words for each response.

Q1. Tell us about your project

• What do you plan to do? • What public health issue(s) will your project address? • Where will your project take place or be based? • Who will deliver it and how will you engage participants or volunteers? • What experience or skills do you/your organisation have to deliver this project successfully? • How will you collaborate with partners or other stakeholders?

Q2. How will your project benefit the target population?

• Who will benefit from your project (e.g. individuals, families or communities)? • What outcomes do you expect for participants and how will you measure them? • How will your project help to reduce health inequalities? • What makes your approach unique or innovative?

Q3. How will you deliver the project successfully?

• What does success look like for your project? • How will you capture and share learning? • What are your plans for sustainability or legacy after the grant ends?

Q4. How will you measure success?

• How have you calculated your project costs? (Please include a detailed budget plan). • How will you meet the grant’s criteria, aims, and outcomes? • What systems will you use to record, monitor, and evaluate progress?

Q5. How does your project align with the aims of the Our North Tyneside Plan, which sets out our plan to build a better North Tyneside through five key priorities and how will your project support the Equally Well strategy?

Our key priorities include: - A thriving North Tyneside - A secure North Tyneside - A family-friendly North Tyneside - A caring North Tyneside - A green North Tyneside