Download Autism Innovation Fund: application form

Application form for the Autism Innovation Fund, national co-ordination of
awareness and the champions network 2014/15.
Section 1:
Applicants Details
Section 2:
Revenue Funding – for innovation fund proposals
Section 3 :
Grant funding for national co-ordination of local awareness and the champions network
Section 4 :
Financial information
Before completing this application form, please read the guidance on making an application and on
eligibility.
Section 1
Applicant Details
Name
Position
Organisation Name
Address
Telephone Number
Email Address
Your Organisation
Legal name
Trading name (if different
from above)
Chief Executive
Charity number (if
appropriate)
Company number (if
appropriate)
Address
Phone number
Email address
Brief description of services
your organisation provides.
Please outline how your
organisation is managed.
Section 2 -
Revenue Funding – for Autism Innovation Fund projects
Please tick the heading you are bidding under.
Advice and information
Gaining and growing skills for independence
Early intervention and crisis prevention
Employment
Project Title
Outline of proposal,
including highlighting its
objectives and strengths.
(no more than 750 words)
What are the expected
outcomes and how will your
project make a difference to
the lives of people with
autism, their carers and
families?
How long has your
organisation worked in this
area?
Funding applied for (£)
Evidence of assessment of
local need.
Have you a contribution of
funding from another source
and does this allow the work
to be sustainable?
Contact details of partners or service links in delivering project:
Partner/s
Evidence of engagement
with local commissioners,
the local Autism Partnership
Board or the Autism Lead,
and people with autism.
How will you monitor and
evaluate the outcomes of
your proposal and what
indicators will you use to do
so?
Section 3
National co-ordination of awareness and the champions network 2014/15. Only third sector/voluntary
groups are eligible to apply.
Outline of your proposal
including highlighting its
objectives and strengths.
What are the expected
outcomes?
How long has your
organisation worked in this
area?
Funding applied for (£)
Evidence of engagement
with people with autism.
Contact details of partners you are making the bid with
Partner/s
Experience of working at a
national and local level in
this area.
How will you monitor and
evaluate the outcomes of
your proposals and what
indicators will you use to do
so?
Section 4
Financial Information
What is the total amount of
funding you applying for?
Please identify any VAT
How have you calculated
this figure?
When will the project start
and end, or when will the
work be carried out?
Bank Details
Bank Name
Account Number
Sort Code
Documentation
Please enclose the following supporting documentation:
Annual Accounts if a
commercial or third sector
organisation.
Budget plan for proposed
project.
The closing date for applications is 17.00 on Tuesday 26th August.
Applications should be emailed to [email protected]