Grant Funding Application

Please refer to the Grant Applications Guidelines when submitting this form.

Application Guidelines

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Step 1 of 4

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Details of the Grant Applicant

This is the person to whom all correspondence will be addressed

Your Name

First Last

Job Title

Hospital / University / Department

Your Email Address

Enter Email Confirm Email

Telephone

Fax

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code

Details of the Grant

A little more detail on the grant application.

Total Grant Amount Requested

Monetary amount in GBP

Term of Grant

A one-off payment or length of research?

What is the grant for?

Please give a breakdown of costs & include details of any other Grants applied for in relation to this request.

For applications that include staffing costs

Please provide details of the Trust or University and any staff members.

Hospital Trust or University

Is the grant for either an NHS Hospital Trust or a University?

Hospital Trust

University

Establishment

The name of the trust or university.

Staff Members

What are the staff member(s) names, if known? Add more rows if needed by clicking on the '+' symbol.

Name of staff member

The NHS and Head and Neck Patients

Some details about how this will impact both the NHS and patients.

What is the benefit to the NHS and why can't the NHS fund this request?

Both for your hospital/university link and for the NHS generally, charitable funding requires that NHS funds are unavailable. It is not acceptable to simply state, “The NHS has no funds”. We want to understand why the NHS is not able to fund it, yet still wants the charity to consider funding.

Please explain in basic terms how this will benefit head and neck patients and what you hope to happen with the outcome of this grant

In effect, we are looking for a layperson’s explanation of what the point of funding this will be – i.e. you buy a piece of kit, or change a way of doing something, but what will be the difference to patients?

Charity Recognition

Some details on how Get Ahead will be recognised as funding this grant.

How will the charity be recognised for it support?

Please detail the opportunities for case studies, PR, naming rights, etc.

Is there any interlectural propery (IP) potential that could come out of this grant? If so, please explain how the charity will be recognised.

If there is not any IP potential, please state that below.

What can you do or have you done to help fundraise for the charity in support of this request?

Some charitable requests can be granted straight away. Some require additional fundraising. Your support will help us increase the number of grants we can approve.

File Upload

If there are any files that you think may help your application please upload them below.

Drop files here or

Accepted file types: png, jpg, pdf, Max. file size: 6 MB, Max. files: 10.

Terms and Conditions(Required)

To the best of my knowledge, I declare that the information provided in this application is true, accurate and complete.

I agree to the terms and conditions.

Comments

This field is for validation purposes and should be left unchanged.

Grant Funding Application

Details of the Grant Applicant

Details of the Grant

For applications that include staffing costs

The NHS and Head and Neck Patients

Charity Recognition

Information

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