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Big Bite Grant Application Form

Closing date deadline: 8th October 2010.

To apply for a grant, please complete all the fields with as much information as possible. Please read carefully through the guidance notes, before completing the form. If you would prefer to print off and post your application form please click here for a PDF version.

Fields marked * are required. When you have finished, click the 'Send' button at the bottom of the page.

If you have submitted you application online and have not had a response within 2 weeks to confirm receipt, please contact Eatsome on 01209 216967

Please complete all mandatory fields marked * below.

Section 1: Contact Details

Your name *
Name of organisation *
Position held by applicant *
Contact address *
Postcode *
Email *
Contact telephone *
Contact mobile *
Type of group *
If other please specify
About your group *
Does your group have ILCM accreditation? *

Section 2: Project Overview

Title of your project *
Type of project *
If other please specify
Brief description of your project (max 300 words) *
Aim of project *
Key outcomes *
Location of project *
District *
Who will benefit? (please give estimated numbers for each age group)
0 - 4 *
5 - 11 *
12 - 25 *
26 - 64 *
65 + *

Section 3: Needs assessment and sustainability

How have you identified a need for your project and who did you consult with? *
How will your grant be sustainable beyond the life of the project?
Project management *
Funding *
Impact *

Section 4: Finance

Item	Total cost	Other cash income	In kind income	Grant request










Total budget costs

Details of other income:

Own fundraising	£
Local authority	£
Primary care trust	£
Other public source	£
Other:	£
Total additonal funding: Total should equal total other income in table above	£

Details of in kind support:

Labour	£
Specialist support	£
Private sources	£
Professional sources	£
Other:	£
Total in kind support: Total should equal total in kind income in table above	£

Make cheque payable to *

Section 5: Milestones

Quarter 1: April - June 2010 *
Quarter 2: July - September 2010 *
Quarter 3: October - December 2010 *
Quarter 4: January - March 2011 *

Section 6: Monitoring

How will you monitor and evaluate your project’s progress towards achieving your aims and outcomes?
Monitoring *
Evaluation *

Section 7: Declaration

I declare that:

The information given on this form and in any other documentation that supports this application is accurate and correct to the best of my knowledge.
I understand that misleading information, failure to comply with the grant terms and conditions and inappropriate use of funds (not in line with that agreed with Eatsome) could render my grant application invalid and any grant funds received by us will be liable for repayment.
My organisation will take all reasonable precautions to ensure that grant funds received will not be misused or misappropriated in any way. In the event of suspected or detected fraud, I understand that this could result in the matter being referred to the Trust’s Counter Fraud Specialist for investigation.
Project funding will not be used for statutory provision, personal gain, staff time or for profit and is additional to current provision.

Information for administration of the grant will be kept and shared within Eatsome and some information may be shared with partners during consultation for funding. We may also share more widely information such as project reports, photos, monitoring and evaluation summaries. We are conscious of the need to protect vulnerable groups and individuals. Please ensure that you do not share with us any information (such as photos) which individuals within your group have not given permission for and let us know of any particular considerations we should make in relation to the information you supply. Your signature on this form is treated as confirmation that Eatsome may use the information you have supplied to us under the terms of the Data Protection Act 1998.

Tick box to indicate that you agree to the above declaration *

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