Gareth Cumming Adventure Memorial Award

Gareth Cumming Adventure Memorial Award

Application Form
About the Award

To honour the memory of the late Gareth Cumming (member and Trustee of the BBS) we run an annual award which will be a lasting legacy in his name. The Gareth Cumming Adventure Memorial Award will be awarded to a single individual annually for an amount up to £1,000. We are inviting anyone who has OI over the age of 18 to apply.

Closing Date 19th April

Who can apply for a grant?
- We consider requests for funding which will be of a direct benefit to an individual with a diagnosis of Osteogenesis Imperfecta who is 18 years or over.
- Applicants must reside either in the UK or Ireland.
What you can apply for?

Perhaps you want to travel independently, visit a new location, meet people or learn something new. Having OI may put hurdles in your way; however, Gareth would have said: ‘Nothing is impossible’. You can apply for funding for any activity that will provide you with new opportunities.

How do you apply?

You must complete this application form.

Do I need to be a member of BBS to apply?

No, the grant is open to anyone who lives in the UK or Ireland, has OI, is over 18 and meets the other eligibility criteria set out in the application form.

Can I apply if my activity would cost more than £1000?

Yes, but we will not be able to release the £1000 grant until we know that your activity is fully funded. You will need to secure the remaining funds within 3 months of a successful application.

Costs the Grant will cover:
- Cost of Travel (flights, train, mileage)
- Cost of Accommodation
- Activities/Training
  
  For more information or to discuss a speculative application, please contact us on 01382 204446 or email admin@brittlebone.org
Please note

We cannot fund retrospectively.

For travel abroad, you must have a valid passport and visa prior to travel funds being transferred.

The grant must be used within two years of acknowledgment.

After your application has been submitted
- Decisions will be made and applicants notified approx 1 month after the closing date.
- We will require the individual to forward quotes/receipts for any costs.
- Funds will either be transferred or we may pay the supplier direct.
Funding Criteria

The individual awarded a Grant will be required to submit a short biog with some images about their adventure, highlighting how the award has made a difference to their life. We may ask for approval to use this on various social media platform.
Application Form- Please Complete all Sections
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile*
Please enter a valid phone number.Format: (000) 000-0000.
Daytime Telephone
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
TelephoneEmailLetter
Applicant's Medical Information
Please confirm you have been diagnosed with Osteogenesis Imperfecta (OI)*
Please state YES/NO
Please state type of OI if known. (For example Type 1,2,3 or mild, moderate, severe)*
Do you have any other medical conditions you wish us to know about (ie epilepsy, autism, scoliosis, hypermobility etc)? If so please provide details.
Details of Travel (if applicable)
Where do you plan to travel?
When do you plan to travel?
How many days do you plan to be away?
Will you be travelling alone?
YES/NO
Details of Activity (if applicable)
What activity will you do? Short answer required, you can tell us more later in the application.
When will it take place?
How long will it take?
Will you require an assistant?
Financial Support for Individual applying
Cost of Travel
Cost of Accommodation
Cost of Activities, Training, Registrations
Total Amount you are Applying For*
Any other costs expected (not listed above) If the grant is to be used to part fund an activity, please indicate how you plan to obtain the remaining funding.
Please give details of any other costs you expect to fund for yourself (i.e carer, family member etc)
Further Information
Please tell us how the travel/activity you have described above will transform your life and give you a sense of adventure in the spirit of Gareth Cumming?*
Please tell us why you have chosen this particular destination/ activity and what you plan to do during your time?*
Please tell us anything else you think we would like to know. (This could be hobbies, interests,things you have done that you are proud of, things you would like to do in the future)*
Data Protection
The Data Protection Act 2018 regulates how we may collect and use the information you have provided in this form. The Brittle Bone Society will use the information provided to process your application. As health data is included in this application, the signer of this application is confirming to BBS that the applicant has consented to the information provided being used by BBS for this purpose. More information about how we use your personal data can be found in our Privacy Notice.

The applicant has the right to withdraw this consent. If consent is withdrawn, we may not be able to proceed with your application. There are further rights held by the applicant under the Data Protection Act 2018.

Please contact admin@brittlebone.org if you have any questions concerning BBS's use of the information in this application or wish to exercise any rights under the Data Protection Act 2018 regarding it.
Consent
By signing the application, you confirm that you have read the terms of the grant, that the details you have submitted are accurate and that you have consented to the use of your personal being used by BBS to process this application as described above.
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Gareth Cumming Adventure Memorial Award

Application Form- Please Complete all Sections

Applicant's Medical Information

Details of Travel (if applicable)

Details of Activity (if applicable)

Financial Support for Individual applying

Further Information

Data Protection

Consent