1. Name of organisation applying:

2. Amount requested:

3. What is the purpose of the grant? Please give an outline of the project:

4. Please describe the impact of the programme. e.g. who will benefit, and how will you measure success?

5. What is your experience in delivering programmes like this?

6. What other sources of funding are you considering? Have you been offered any other funding?

7. If you were only offered a proportion of the amount of funding requested, how would this affect the delivery of the programme

8. Do you have any connection to any of the trustees of the Diversity Project Charity?

9. Please confirm that you will seek to achieve value for money for your project by securing goods and services at reasonable prices. 9. Please confirm that you will seek to achieve value for money for your project by securing goods and services at reasonable prices. Yes No

10. Please confirm that your organisation will keep full and proper accounts and records, including invoices and receipts, which will show how the money from TDPC has been used. 10. Please confirm that your organisation will keep full and proper accounts and records, including invoices and receipts, which will show how the money from TDPC has been used. Yes No

11. Please confirm that your organisation has an equal opportunities policy and, if working with children, young people or vulnerable adults, a safeguarding policy; that these policies are carried out and regularly reviewed to ensure they adhere to current legislation and regulations. 11. Please confirm that your organisation has an equal opportunities policy and, if working with children, young people or vulnerable adults, a safeguarding policy; that these policies are carried out and regularly reviewed to ensure they adhere to current legislation and regulations. Yes No

12. Please confirm that your organisation is following all current statutory requirements and other laws and regulations relating to the project and its work including: adherence to employers’ liability insurance; the national minimum wage; the working time directive; health and safety; safeguarding of children, young people and vulnerable adults; data protection; Charity Commission requirements; intellectual property rights legislation; anti-slavery and human trafficking and UK and foreign tax evasion. 12. Please confirm that your organisation is following all current statutory requirements and other laws and regulations relating to the project and its work including: adherence to employers’ liability insurance; the national minimum wage; the working time directive; health and safety; safeguarding of children, young people and vulnerable adults; data protection; Charity Commission requirements; intellectual property rights legislation; anti-slavery and human trafficking and UK and foreign tax evasion. Yes No

13. Please confirm that you will tell us of anything which happens during the period of the project/grant which would affect your compliance with 6-10 above. 13. Please confirm that you will tell us of anything which happens during the period of the project/grant which would affect your compliance with 6-10 above. Yes No

14. Name of person completing this application and contact details.

15. Email address

16. Telephone Number