East Central Area Partnership Holiday Grant January â€“ August 2012 For work with vulnerable children and young people Application Form Please read the guidelines before completing this form 1. Which part of East Central do you plan to work in?
2. Are you applying in partnership with another organisation?
3. Your details: Name of group(s) or organisation(s): Name of contact person: Contact address: Post code: Telephone number: E-mail address:
4. Please tell us briefly about your group or organisation: What do you do? Which groups of vulnerable children and young people do you work with?
5. Why is your project needed? How do you know? Please describe how you have consulted with children and young people.
6. What gaps in provision does your project meet? How do you know? Who have you liaised with in your neighbourhood? (e.g. schools, charities, faith groups, community groups, youth & play, childcare, neighbourhood partnerships)
7. Please tell us about the programme of work you are asking us to fund Target group:
Name of your project:
Description of activities:
8. Please shade boxes in this grid to show when the work will take place
February Â˝ term April (Easter holiday) May Â˝ term July/August (summer holiday)
9. Impact of your work Please state how your project will impact on one or more East Central Area Partnership outcomes. Outcome
What impact will your project have on this outcome? (e.g. 15 vulnerable young people will take part in sports activities and have increased confidence as a result)
How will you measure the impact of your action? What evidence of impact will you provide?
1. Improve the emotional health and well being of vulnerable children and young people aged 0 -19 2. Increase the engagement of vulnerable parents and carers including family support and access to services and supporting families with multiple complex needs 3. Increase positive development opportunities for vulnerable children and young people aged 0-19 4. Improve school attendance by 1%
5. Improve Cultural Competency and Community Cohesion
10. How much grant are you asking for? ÂŁ______
11. Please set out a breakdown of the total costs of your project, showing us which items you are asking us to fund and which are being funded from another source. Item
Please tick if you are asking us to fund this item
12. Your group(s) needs to have the documents listed below Please enclose/email copies of these documents 1. A formal constitution 2. An Equal Opportunities Policy 3. A Health and Safety Policy 4. A Safeguarding Policy (this is required if you are working with Children and Young People or Vulnerable People) 5. Public Liability Insurance - required if you are working with the general public.
13. Is your group(s) Ofstedâ€“registered or is it in the process of being Ofstedregistered? (Not all groups are eligible for Ofsted registration. If you are not sure whether this applies to you, please contact Julie Bassett at BAND at Julie@bandltd.org.uk )
Declaration Name of person submitting the form: Signature: Date: Position in the group or organisation: Please email this form to Rachel Rodgers, East Central Extended Services Manager at Rachel.firstname.lastname@example.org by 5pm Friday January 13th 2012.