Peer Support Grants Application Form

 

Deadline: FRIDAY 16th November 2018 5.30pm

We recommend saving your application on a Word file regularly whilst you are working on it and retaining a copy of any long text fields. You should use an Internet Explorer web-browser where possible as other browsers (e.g. Mozilla Firefox, Safari & Google Chrome) may cause issues with saving your work.

SECTION 1  About You

Guidance Note: This section is mandatory and needs to be completed by the lead organisation.

Organisation Details
We are required by law to ask for your permission to record details of your organisation and staff, primarily your contact details and corporate information about your organisation. The record of your organisation will be stored in an electronic contact management system. Paper copies of your data may also be stored securely. Your organisation details may be processed anonymously to analyse the state of the voluntary sector in Hackney.
Lead Contact
We are required by law to ask for your permission to record details of your organisation and staff, primarily your contact details and corporate information about your organisation. The record of your organisation will be stored in an electronic contact management system. Paper copies of your data may also be stored securely. Your organisation details may be processed anonymously to analyse the state of the voluntary sector in Hackney.
Application details
please state names of Partners (we may contact you for more information on these)
Have at least four members on its governing body or Board of Directors?
Require two unrelated people to authorise cheques and make withdrawals (including debit card or internet purchases and cash withdrawals)?

 

SECTION 2: The Long Term Condition you are focussing on and the community you will work with

Guidance Note: We want you to be very specific about the Long Term Condition(s) you are focussing on.
e.g. Older women from African/Caribbean Backgrounds living on Woodberry Down Estate or Young adults aged 18-30 from refugee backgrounds who have mental health issues or Turkish speaking men who have lung disease. Guidance Note: This is your opportunity to spell out to us very clearly about your target group for the project.
Guidance Note: This is your opportunity to explain to us what you think the particular needs and issues are for people in your chosen community in managing their Long Term Condition. You can use up to 200 words. (10 points)
Guidance Note: This is your opportunity to explain to us your outreach methods and how you will ensure that you reach people with Long Term Conditions who may be furthest from services. (10 points)
..please tell us how you will ensure NEW participants who have not accessed your previous projects. (If you have NOT had one of these grants before you can answer ‘Not Applicable’ here) (100 words) Guidance Note: We need to ensure that our grant funding provides benefits for people for people who have not taken part in a previous project. Please describe how you will engage new people.

 

SECTION 3 The Peer Support Courses

Guidance Note: Please give us an overview of your aims and objectives for the course. Remember the aim of this grant is to promote long term behaviour change, self-management and social networks. Please summarise in no more than 100 words what your Peer Support course will offer. (10 points)
Guidance Note: This is your opportunity to tell us how these activities will bring improvements for the People you are working with. You may not need to tick all boxes in an answer for ALL of the sections below.
Guidance Note: This is your opportunity to tell us how these activities will bring improvements for the People you are working with. You may not need to fill in an answer for ALL of the sections above, but please explain clearly which of the bullet points above your project will address and how it will address these. E.g. Support people to better manage their own health: by explaining the important role that exercise Plays in managing diabetes and arranging practical exercise sessions. (20 points)
Guidance Note: Please outline the actual activities planned for each week of your project. To get a high score in this question we want to see a detailed breakdown of what activities will happen at each session. Download Activities Template - please make sure to use this activities template as part of your application, complete it and upload it below. (10 points)
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.
Guidance Note: Please say how many people your activities will reach with an explanation of how you worked out this number. (10 points)
Guidance Note: This is your opportunity to tell us about who will be doing the work. List the people who will be in your project delivery team -will it be a paid member of staff, a volunteer, yourself? What skills or experience do they have that will enable them to do this project? What is your organisation’s track record in delivering projects with your community? Please explain in no more than 300 words. (10 points)
Guidance Note: This is your opportunity to tell us about your management and governance arrangements including: Who will supervise the staff or volunteers who will be working on this project? How you will ensure consistent quality during your project activities and how you will ensure that inaccurate advice is challenged? What Policies and Procedures do you have in place to ensure this work can be delivered to a high standard? (10 points)
You will be trained in the monitoring processes if you are successful. Please state here that you agree to attend the Grant Monitoring Training and agree to collect the required information.

 

SECTION 4 Project Plan

Please enter numbers only with a comma (,) separator for thousands and dot (.) separator for decimals.
£
Guidance Note: This is your opportunity to show us how you plan to: • put the service in place • publicise the service • collate the monitoring information. (The monitoring and evaluation must be completed in the agreed templates. Please note that it is a requirement of the grant that staff or volunteers to attend Grant Monitoring training as outlined on page 4 of the guidance). Download Project Plan Template - please make sure to use this Project plan as part of your application, complete it and upload it below. (10 points)
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.
Using the Activity Plan attached and Actions that you described in Section 1, complete column A stating the activity; Column B stating the Budget items or activity costs and Column C the (total amount requested for activity) Guidance Note: In the breakdown of cost section, write in how much this will cost. You may need to think about how many staff hours are needed. We would like to see all associated costs included for you to carry out your proposed activity. Download Breakdown of Costs Template - please make sure to use this template as part of your application, complete it and upload it below. Remember you can request up to £4,000 overall. (10 points)
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Section 5 Organisation References

This section is mandatory.  Please give referee details from the director of a partner organisation or a funder who knows about the work you do and who can talk about work you have carried out.

Referee
We are required by law to ask for your permission to record details of your organisation and staff, primarily your contact details and corporate information about your organisation. The record of your organisation will be stored in an electronic contact management system. Paper copies of your data may also be stored securely. Your organisation details may be processed anonymously to analyse the state of the voluntary sector in Hackney.