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2012-2013

Health Challenge Cwm Taf

Cwm Taf

Crystal Trophy Award

Nomination Form

Name of Project/Activity Contact Person Group/Organisation Postal Address

Post Code Telephone Mobile No Email

Please tick relevant status of your group (tick all boxes which apply) Community Group Registered Charity Local Voluntary Group

I I I

Communities First Partnership Other I Please state

Are you a member of Interlink or VAMT?

Yes I

I

No I

Cwm Taf


2012-2013

Health Challenge Cwm Taf

Cwm Taf

Cwm Taf

Crystal Trophy Award

Tell us about your project and why you deserve a Crystal Trophy Award? (Include; clear aims & objectives, the identified need, how your project contributes to healthy lifestyles and to preventing ill-health. Provide examples of how your project benefits others?)


2012-2013

Health Challenge Cwm Taf

Cwm Taf

Cwm Taf

Crystal Trophy Award

How long has your Project been running? How many people benefit from the project? How many volunteers are involved? If you won the Crystal Trophy Award how would you develop or enhance your project? We will contact you in 6 months to see how your project has developed.

Are you working in partnership with other groups/organisations on this project? Who are your partners? (We may need to contact your partners for information)

Yes I

No I


2012-2013

Health Challenge Cwm Taf

Cwm Taf

Crystal Trophy Award

How is the project funded?

In terms of health & safety; how do you ensure that your project beneficiaries are kept safe?

Cwm Taf


2012-2013

Health Challenge Cwm Taf

Cwm Taf

Cwm Taf

Crystal Trophy Award

Has the project/activity been evaluated? Internally Evaluated I

Externally Evaluated I

Not Evaluated I

Details:

The Closing Date for Nominations: Friday 8th March 2013 We may come back to you for further information. Please mark your completed form “Crystal Trophy� and return to: Rhondda Cynon Taf: Anne Morris, Interlink, 6 Melin Corrwg, Cardiff Rd, Upper Boat, Pontypridd CF37 5BE 01443 846200 email:amorris@interlinkrct.org.uk Merthyr Tydfil: Sharon Richards, VAMT, 89-90 High St, Pontmorlais, Merthyr Tydfil CF47 8UH 01685 353900 email: sharon.richards@vamt.net


Form Electronic