TheApplication form

Step 1 of 9

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Legal name of organisation

Working name

Year your organisation was established

Legal entity

Registered number

Title

Name of main contact

Position held

Chief Executive (if different from main contact)

Chair of Trustees

Organisation address

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

Correspondence address (if different)

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

Organisation telephone

Contact email address

Contact telephone

Website

Have you applied to The Dukes Foundation before?

Yes

Primary beneficiaries and numbers

Geographical area(s) in which you work

How many paid staff (full-time equivalent) do you employ?

How many volunteers do you have?

Annual accounts year ending

Total income

Total expenditure

Free reserves

Project Name

Amount requested from the Dukes Foundation

Appeal Summary

A summary of your request in no more than three sentences.

Project Start Date

DD slash MM slash YYYY

Project End Date

DD slash MM slash YYYY

Project beneficiaries:

In addition to a description of your potential beneficiaries, please include estimated numbers.

Does your work fall into one of the Dukes Foundation’s areas of special interest?

Mental health and wellbeing support for young people

Learning and the power of opportunity

Positive, sustainable changes for our planet

Research and innovation in children’s healthcare

Anticipated Outcomes and the percentage/numbers of beneficiaries expected to make progress towards these outcomes

Total project costs

Please send us an outline proposal which answers the following questions on no more than three to four sides of A4 paper:

1. Please outline the broader work of your organisation.
2. Describe the work you are asking us to fund and how you would like us to help.
3. Please provide a brief summary of the evidence that this work is needed.
4. What particular expertise and experience does your organisation bring to addressing this issue?
5. Please reflect on how your proposal also matches the other characteristics of organisations and projects we like to fund (as set out in our application guidance).
6. What is it about your proposal that can be replicated by other organisations or where other organisations can learn lessons?

Please enclose the following:

An income and expenditure budget for the proposed project showing what has been raised and from whom, where you would like us to make a contribution and how much, and how any shortfall will be met.
A copy of your most recent annual accounts.
If the request is for work which follows on from a recent pilot, please enclose the relevant findings or evaluation.

File

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Max. file size: 10 MB.

The Dukes Foundation is committed to protecting your data and privacy in accordance with the provisions of the Data Protection Act 1998 and the General Data Protection Regulation (GDPR) 2018. Our privacy notice tells you what to expect when we collect your personal information. It tells you how we will use the information and the rights you have in relation to this. To read our privacy notice, please visit our website.

Consent

I confirm that to the best of my knowledge all of the information contained within the attached application is correct.

Signature

Date

MM slash DD slash YYYY

Name and position in organisation

Phone

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

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Your name

Your email