Duchy Health Charity Grant Application

Grant Application form
Completing your application

In order to complete your application you will require the following information and documentation:
1. Organisation details - address, contact details, year of inception.
2. Number of staff/volunteers and level of any relevant DBS checks.
3. A brief history of your organisation and its aims and objectives.
4. Details of your project, its benefits, aims and objectives.
5. How your project will continue and be funded beyond any grant provided by Duchy Health Charity.
6. The amount of funding you are requesting and a detailed breakdown of how the funding will be used.
7. Details on any other organisations who offer the same or a similar service
8. Details of any other grant funders to whom you have applied, or would be eligible to apply, for funding.
9. The following documentation in Word, Excel or PDF format for upload:
- For grant applications over £5k, a full set of accounts for the last financial year
- For grant applications over £5k, a copy of your organisation's Safeguarding Policy
- For all CIC's/CIO's, a copy of your governing document
You also have the opportunity to provide a Case Study and further file uploads to support your application.

When completing your application you can save your progress as you go - to do so click the 'Save' button at the bottom of the page, this will enable you to enter an email address to which a link will be sent so that you to continue your application at a later date.

When you are satisfied that your application is complete just submit it to us for consideration by using the 'Submit' button at the bottom of the page.

Please note that once your application has been submitted you will no longer
be able to access it to make changes.

If you become aware of an error within your submitted application please contact us via helen@duchyhealthcharity.org with details of your required amendments. We will then be able to update your application.

1. About you and your organisation
Project name*
Organisation name*
Organisation type*

Registered charityCICCIOSocial enterprisePrivate businessNHSOther
Date of inception
Year your organisation began operating
Number of paid staff
Number of volunteers
What was your organisation's turnover (£) in the last financial year?*
Applicant name*
Position within organisation*
E-mail address*
Contact phone number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
Website address
Link to Facebook page (if applicable)
Link to LinkedIn page (if applicable)
Link to Instagram page (if applicable)
Link to Tik Tok page (if applicable)
Link to any other social media page (if applicable)
Brief history of your organisation and purpose (max 500 words)*

Please let us know why your organisation exists and its purpose0/500
Future aims and objectives of your organisation (max 500 words)*

What are the key things and impacts that your organisation is aiming to achieve in the future?0/500
Case study (max 500 words)

Please provide details of a recent case study to illustrate the work and impact of your organisation.0/500
2. About your project
Is your project health and wellbeing related?

YesNo
Will your project improve the health and wellbeing of the people of Cornwall and the Isles of Scilly?

YesNo
How many people do you estimate will benefit from your project?
Does your project support any of the underrepresented/at risk groups in Cornwall and the Isles of Scilly? (Please tick all that apply)

Paid and unpaid carersKey/essential workersLong Covid patientsPhysical and/or sensory impairmentYoung peopleOlder people (65+)Mental health conditionsDifferent ethnic groups e.g. European, BAME, gypsies and travellersVeteransSubstance misuseHomelessDomestic violenceSelf-harm and/or risk of suicideProblem gamblingOther
Project start date*

DayMonthYear
Date
Anticipated project completion date*

DayMonthYear
Date
Project aims, objectives and outcomes - what the project will deliver? (max 500 words)*

Please explain the purpose of your project and what it is designed to achieve0/500
Demonstration of local need (max 500 words)*

Please provide evidence of how you know that there is a need within Cornwall/your area for the project0/500
How will your project benefit the people of Cornwall and the Isles of Scilly? (max 500 words) *

Please explain what benefits the people of Cornwall and the Isles of Scilly can expect to realise from your project.0/500
How does your project/offer fit with NHS provision? (max 500 words)*

Please explain whether your project will support, complement or collaborate with existing NHS services0/500
Are there any other organisations providing the same or a similar service? If yes, please provide details (max 500 words)*

Please explain whether your project will support, complement or collaborate with existing NHS services0/500
Project success measures - how will you measure whether the project has been successful? (max 500 words) *

It is important to us that projects can demonstrate how they plan to establish whether they have been successful in achieving their objectives. Please tell us how you plan to do this.0/500
How will future phases of, or long term support for the project be funded? (max 500 words)*

It is important to us that projects we fund are sustainable into the future. Please tell us how you plan to achieve this.0/500
3. About the grant you are applying for
Grant amount requested (£)*
Justification for the grant and resources required (max 500 words)*

Please explain why you think Duchy Health Charity should support your grant application.0/500
How the grant will be spent? (max 500 words)*

Please explain exactly what you will use any grant award for, including a detailed breakdown of costings and how the grant will be spent.0/500
Have you applied to any other grant funders for support? If yes, please state who and what funding you have already secured (max 500 words)*

0/500
Will a grant from Duchy Health Charity help to leverage grant funding from elsewhere? If yes, please provide details (max 500 words)*

0/500
4. Document upload

Upload all applicable documents listed below. Click on the "Browse..." button to select a file from your computer. You can upload any common file format (PDF, .doc, .docx., .xls, .xlsx, etc.)
For all Grant applications over £5,000 please attach a full set of accounts for the last financial year

Upload a File
5Mb filesize limit applies Cancelof
Please attach a copy of your organisation's governing document

Upload a File
5Mb filesize limit applies Cancelof
Please attach a copy of your organisation's Safeguarding Policy

Upload a File
5Mb filesize limit applies Cancelof
Does your organisation conduct mandatory safeguarding refresher training for all staff at least annually?

YesNoOther
Please attach any other relevant documents you wish to share

Upload a File
5Mb filesize limit applies Cancelof
5. Further information
Is there any other supporting information you would like to provide? (max 500 words)*

0/500
If your application is successful would you be willing to be featured as a ‘case study’ on our website?

YesNo
Where did you hear about Duchy Health Charity?

Internet searchGrant finding databasePrevious applicantCornwall VSFFacebookLinkedInCharity CommissionWord of mouthOther
Should be Empty:

Grant Application form

1. About you and your organisation

2. About your project

3. About the grant you are applying for

4. Document upload

5. Further information