This is a sample application form. Applications will only be accepted through our online system at neaco.fluidreview.com.

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1 This is a sample application form. Applications will only be accepted through our online system at neaco.fluidreview.com. Before completing your application we recommend you read our eligibility and criteria guidelines on our website and the application guidelines provided below. Please note that grants should be between ,000 and will only be awarded to projects taking place in East Anglia. All projects must be completed by 31 December If you have any questions about completing the form please get in touch with us at funding@takeyourplace.ac.uk or by calling The application form may take minutes to complete. You can save a partially completed application form and return to it later. Once you have submitted your application you will not have any further opportunities to amend it. You should expect to hear the outcome of your application within 8 weeks of the close of applications. The application consists of 3 sections, please complete all of them. Applicant details Please provide the main applicant's contact details. This is the person who will be responsible for receiving any grant money awarded and accepting our terms and conditions. They will also be responsible for reporting back to us. Project details Please provide clear and concise information about the objectives of your project, target audience, what you are planning to do and the impact that you expect the project to have. neaco will use the information provided in this section to determine whether the project meets our objectives and criteria. Finances We need to see what the grant will be covering and will look at whether the costs are good value for money with respect to the project. You are provided with a table to categorise costs in relation to your budget, for items that do not appear in the table please summarise the costs in Other and provide further details in the comment box provided. Our website provides a list of items that will not be funded by neaco. 1

2 Applicant Details Contact Details Title: First Name: Last Name: Role/ Job title: Telephone number: Organisation Details Organisation name: Registered Address: Invoice address (if different): Website: VAT registration number (if registered): Company/Charity type (Ltd, Plc, etc.): Company/Registered Charity Number: Project Details Project Title Project Summary Please provide a clear and concise description of your planned project including overall aims and a brief description of what you are planning to do. How will your approach contribute to increasing the number of students from target wards progressing to Higher Education? This may include any course of prescribed HE, whatever the mode of study (HND, HNC, foundation degree, degree, higher apprenticeship). What evidence do you have that your proposed approach/type of activity is impactful? How is your approach innovative, compared with existing activity for your target audience? 2

3 What will be the legacy of the project beyond the grant period? How will you help to ensure future development and sustainability of the project beyond the grant period? Which county will your project take place in? Projects must be working within either rfolk, Suffolk or Cambridgeshire. Applicants can only apply to one county in a given application round. rfolk Suffolk Cambridgeshire and Peterborough Is your organisation address also the location of your activity? If no, where will your project take place? Please include the names of venues, towns, cities or geographical regions where your activity will take place: Who is your target audience? This should include the parents, families or communities of young people in the age range of (years 9-14). In total, how many people do you estimate will participate in this activity? How will you target activity towards one or more NEACO target wards? How will you reach this audience and embed the project in the local community? Please outline how you will promote the project to reach your target audience, and why your project is relevant to them. Who will be delivering your project? This should include all staff, volunteers and project partners. Please provide us with information about any other partners involved in the support and delivery of the project. Will your project involve NEACO staff in either the delivery or development of the project? If yes, which NEACO staff member? What will their role be? 3

4 Please tell us briefly about the background and experience of those delivering the project, highlighting your understanding of the local community and barriers to progression to higher education. To enable tracking and evaluation, we would like to collect the following data from student participants: Full name, date of birth, postcode. Will you be able to collect this and share it with us (subject to data protection processes)? If no, will you be able to collect participant postcodes and share them with us in an anonymised format? Some Finances How much are you applying for from neaco? This must be between ,000. What is the total cost of your project? Is there a charge for your event/activity? Please provide in GBP( ) any expected income for your project: Please provide a breakdown of the funding that you are requesting The total costs funded by the grant should equal the amount that you have requested in the previous question All amounts in GBP( ) Event or presenter fees Staff cover Venue hire Equipment hire/purchase Consumables 4

5 Marketing Consultancy Subsistence Travel Accomodation Other costs (please specify below) Total cost funded by grant: If you have applied for funding from any other sources, please tell us whether an application has already been submitted, whether the funds have been secured and how you will use the funds. Data Protection The Network for East Anglian Collaborative Outreach (NEACO) consists of the University of Cambridge (including its Colleges), Anglia Ruskin University, the University of East Anglia, rwich University of the Arts, and the University of Suffolk. All personal data provided will be processed and held by, and may be shared, within NEACO, for the purposes of the programme. The data will be used by NEACO to evaluate your application and make funding decisions, and for research purposes including (but not limited to) evaluating the impact of NEACO and other third-party activities. Your personal data will always be safeguarded under the terms of data protection legislation. If you wish to find out more about these uses of your personal data, or at any time wish to withdraw your consent for your data to be held and used, please contact us at: I consent to my data being used in this way 5

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