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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]