A1 *Your organisation name
      
A2 Your organisation address *Address1:      
  Address2:    
  Town:    
  County:    
  *Postcode:    
A3 *Please enter your own name
         
A4 *Please enter your job title
      
A5 *Please enter the most relevant website for the project
For example, this could be your organisation’s website, your department’s website or the lead applicant’s website
      
A6 *Please enter your email address
      
A7 *Please enter your contact telephone number
        
A8 *What is your organisation type?
Please select one
      
A9 Please enter your Registered Charity Number (if applicable)
      
A10 If applicable, what is the Year End date of your most recent financial year, for which published accounts are available?
(Day/Month/Year)
      
At the end of that financial year, what was your organisation's:      
A11 Income?
      
A12 Expenditure?
      
A13 Surplus / Deficit?
      
A14 Unrestricted Reserves Total?
Unrestricted reserves (or 'free reserves') are those which can be used for any purpose deemed appropriate by the charity within its charitable objects
     ?
A15 *What is the purpose of your organisation / centre / department?
Maximum number of characters including spaces: 500 characters
      
A16 Please tick this box if you are happy for the Trust to contact you by email with information about our work, events and other communications.

You can opt out of receiving these communications at any time by sending an email to email@sirhalleystewart.org.uk

      
B1 *What type of project are you seeking funds for? (Research project / Development project / Both / Other)
Please select one
      
B2 *Which of the following themes apply to your project: Medical, Social, Religious?
Please select the option that best describes your project
      
B3 *Does your project mainly take place in the UK or overseas?
Please select the option that best describes your project
      
B4 *Are you applying for a new grant of over £5,000, a new small grant (up to £5,000), or a renewal grant?
Select one
      
B5 *Project Title
Maximum number of characters including spaces: 255 characters
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B6 *Please indicate what stage of development your project has reached (i.e. at the time of your application to the Trust):

Initial idea, Pilot undertaken, Dissemination and Implementation, Other
Please select one

      
B7 *Please summarise your project in lay terms
Maximum number of characters including spaces: 4,000 characters
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C1 *What is / was the start date of your project?
      
C2 *How long do you anticipate the project running?
List number of years
      
C3 *Briefly outline your project timetable (i.e. Year / Funding Required / Bullet point list of major activities)
Maximum number of characters including spaces: 2,000 characters
      
C4 *What is the overall cost of your project?
      
C5 *How much funding are you requesting from the Trust?
      
C6 *What other funding applications have you submitted, or do you plan to submit, regarding this project?
Maximum number of characters including spaces: 2,000 characters
     ?
D1 *What methodology will your project use?
Maximum number of characters including spaces: 4,000 characters
     ?
D2 *How will ethical and governance issues be addressed on your project?
Maximum number of characters including spaces: 2,000 characters
     ?
E1 *What are the overall aims and objectives of your project?
Maximum number of characters including spaces: 2,000 characters
      
E2 *Why is your project needed at this time?
Maximum number of characters including spaces: 2,000 characters
      
E3 *How is your project innovative / ground-breaking?
Maximum number of characters including spaces: 2,000 characters
      
E4 *How does your project fit with the Trust's current Medical, Social and / or Religious priorities?
Maximum number of characters including spaces: 2,000 characters
      
E5 *How will you monitor and evaluate your project?
Maximum number of characters including spaces: 2,000 characters
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E6 If you will be working with any partners on this project, briefly tell us about them here. If not, please skip this question.
Maximum number of characters including spaces: 2,000 characters
      
E7 *What are your plans for dissemination and implementation?
Maximum number of characters including spaces: 2,000 characters
      
F1 What are the specific, measurable outcomes that you predict for your project?
Maximum number of characters including spaces: 2,000 characters
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F2 Who is responsible for the following on your project: Governance, Project Delivery, Reporting?
Maximum number of characters including spaces: 500 characters
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F3 Staff posts - please:

a) List the staff posts that will work on the project,

b) State if they will be appointed to the project in a full-time or part-time capacity (if the latter, how many days per week / what proportion of their time will be spent on the project?), and

c) Justify the amount of time required for each post.
Maximum number of characters including spaces: 2,000 characters

      
G1 Please upload a document containing one-page CV summaries for up to three key people that will be responsible for your project (in PDF or Word Format)
Please note: Re-uploading a file overwrites the currently uploaded file
       ?
H1 Would you like to upload any supporting documents, such as References, Testimonials, or Letters of Support?
Reuploading a file overwrites the currently uploaded file
       ?
I1 Please upload a budget / financial breakdown for your project (in PDF or Excel format)
Please note: Re-uploading a file overwrites the currently uploaded file
       ?
J1 Is there any additional information that you would like the Trust to consider when assessing your application? 
Reuploading a file overwrites the currently uploaded file
       ?
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