Opening Date
-
Year
-
Month
Day
Date
Element 1: Highland Whole Family Wellbeing Fund Application Form
Application Details
If you have completed your Self Assessment Toolkit Form please enter your Unique Id Number here
Please provide your Email address
example@example.com
Project name
1. Please describe the project / proposal including its key aims and activities, evidencing how this supports the ethos of Whole Family Wellbeing
*
0/500
2. Is any other organisation already providing a similar service in the proposed locality?
*
Yes
No
Provide details relating to 'Yes' response
*
3. The following family types are considered to be the most at risk of poverty. Please select any (or all) who are likely to engage with this project?
*
Families where the mother is under 25
Lone Parent Families
Families which include children or adults withdisability
Larger Families(3 or more children)
Minority Ethnic Families
Families with any child under 1
4. What is your application for?
*
New project
Continuation/expansion of an existing project
5. Projected Revenue expenditure for the project/proposal
*
6. Projected CAPITAL for the project/proposal
*
7. Details of any matchfunding (if applicable)
8. Amount requested (to nearest whole number)
*
£ (amount)
Total Project costs
Amount requested from the Highland Whole Family Wellbeing Fund - 10k or below
Your Proposed Outcomes
9. What results or changes will families experience as a result of the proposed project? Please provide one or more outcome(s).
*
Describe Capital Expenditure Item
Outcome 1
Outcome 2
Outcome 3
Outcome 4
Tell us more about your organisation
10. What is the legal structure of your organisation/partnership?
*
Charity
Not For Profit company
Unincorporated association
Trust
Partnership/Collaboration
Statutory Service
Other
11. Registered Charity Number
12. Registered Company Number
13. How many people are on the board or committee that runs your organisation?
*
14. In which locality do you plan to focus your work?
*
Choose the area(s)
Caithness
Lochaber
Mid Ross
Skye, Lochalsh & Wester Ross
Sutherland
Inverness & Inverness-shire
East Ross
Nairn & Nairnshire
Badenoch & Strathspey
Pan Highland
15. Is there a specific geographic community or neighbourhood you will focus on within the above locality?
*
Tell us more about your application proposal
16. Select the date you will start your activity
*
/
Day
/
Month
Year
Date
17. Select the date you will finish your activity
*
/
Day
/
Month
Year
Date
18. Describe how you identified a need for this activity? We particularly want to know how people you hope will benefit from this activity have been part of the process.
*
0/200
Back
Next
Save
19. Describe additional measures you will take to ensure you can break down the barriers to inclusion to reach your target group(s) or any other participants.
*
0/200
20. Tell us how you are working with other organisations, agencies or businesses in your area/locality.
*
0/150
21. Describe how you will apply Fair Work Practices to your project and support staff retention and recruitment.
*
0/150
22. How will your project continue to deliver impact beyond the funding period?
*
0/200
Confirmation
23. Please confirm you have the authority for submitting this application and the potential undertaking it represents
*
Yes
No
24. Attach a copy of your latest independently verified accounts, as required by your governance structure, or a financial statement if you don't yet have one year's accounts
Browse Files
Cancel
of
Signature
*
Print Name
*
First Name
Last Name
Designation in organisation or if applying on behalf of a partnership, your role within it.
*
Save
Submit
Submit
Should be Empty: