Application Form Review
A1 *Organisation name
     ?
A2 *Legal Status
      
A3
*Applicant name (title, first name and surname)

(all correspondence will be sent to the applicant)
         
Job title / Office
60 characters maximum (including spaces)
      
Correspondence address *Address1      
  *Address2    
      
  *Town    
  Region    
  *Postcode    
*Telephone number
        
*Email address
An acknowledgement and a copy of the application will be sent to this address, 60 characters maximum (including spaces)
      
A4
1st Co-applicant name (title, first name and surname)

         
1st Co-applicant job title / office

60 characters maximum (including spaces)
      
1st Co-applicant e-mail address

60 characters maximum (including spaces)
      
A5
2nd Co-applicant name (title, first name and surname)

         
2nd Co-applicant job title / office

60 characters maximum (including spaces)
      
2nd Co-applicant e-mail address
60 characters maximum (including spaces)
      
B1 *Title of the project for which funding is requested
200 characters maximum (including spaces)
      
B2 *Proposed start date (day/month/year)
Must be within 1 month of the grant award letter
      
B3 *Project duration (months)
As a guide 6 months maximum
      
B4 *Amount requested
As a guide £5,000 maximum
      
B5 *Total cost of the project
      
B6 *Have you, your department or ward received funding from the Foundation before
      
B7 *Select which theme best describes your project
      
B8
Which of our strategic aims will your project address
     
Improve the health of the community

      
Improve the patient / carer experience

      
Help transform the healthcare system

      
Reduce health inequalities

      
Investment in preventative medicine

      
B9 Which group will directly benefit from this grant ?
     ?
B10 If other (above), please give details
1000 characters maximum (including spaces)
      
B11
*Short Project Outline

900 characters maximum including spaces
      
B12 *Give a full project outline providing as much as detail as you can, please see help note (? icon) for guidance
4000 characters maximum (including spaces), approximately 500 words
     ?
B13 Please give the name of your management accountant, finance officer or cashier as appropriate
         
B14 How did you hear about the Edinburgh and Lothians Small Grants programme ?
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B15
If you chose Other for B14, please state how you heard about the Grants programme

500 characters maximum (including spaces)
      
*

With reference to B4 and B5 please submit your project cost breakdown using the standard costing template which can be found on our website at

http://www.elhf.co.uk/grant-seekers/small-grants/


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