To nominate Members for a meeting to consider voluntary sector funding assistance for 2007/08.

Size: px
Start display at page:

Download "To nominate Members for a meeting to consider voluntary sector funding assistance for 2007/08."

Transcription

1 Agenda item: 11 Committee: Community Affairs Overview and Scrutiny Date of meeting: 13 th June 2006 Subject: Allocation of Voluntary Sector Funding Assistance 2007/08 - Election of Member Working Group Lead Office: Head of Community Support Services Portfolio Holder: Social Affairs: Cllr J Sheldon Policy/budget ref: E1, E7 Exempt information: None Delegated status: For resolution PURPOSE: To nominate Members for a meeting to consider voluntary sector funding assistance for 2007/08. RECOMMENDATION: THAT UP TO FOUR COMMUNITY AFFAIRS OVERVIEW AND SCRUTINY MEMBERS ARE SOUGHT TO JOIN A WORKING GROUP TO CONSIDER VOLUNTARY SECTOR FUNDING FOR 2007/08. REPORT: 1. At the Community Affairs Overview and Scrutiny Committee on 12 th January members expressed an interest in being involved in the allocation of funding to voluntary organisations for 2007/ Members are reminded that the current budget for voluntary sector funding is 16,500. Last year 42 requests for funding were received amounting to over 50,000. As a result there needs to be a fair system in place to allocate funding. 3. Appendix A is the agreed criteria as a result of member involvement and from the Overview and Scrutiny Review of Support to the Voluntary Sector. Appendix A only includes the medium grant application. However, the small grants application which is principally the same but requires less information from the applicant. 4. It is proposed that the same criteria is used this year with the additional two amendments agreed at the last Overview and Scrutiny Committee namely: It is strongly recommended that requests are no more than 3,000 and that organisations are only permitted to submit one application i.e. applying for funding from either the small or medium grants awards scheme. 5. It is proposed that the Voluntary Sector Support Officer will produce a suggested format for funding for this year on the same basis as last year for the Working Group to consider at their review meeting

2 6. On the basis of members request the option has been introduced for all organisations to receive some funding, although smaller amount than requested for those receiving the lowest points. 7. Up to four Member nominations are requested to join the Working Group to decide on the allocation for 2006/ Following agreement at the Working Group meeting the application packs for this year will be released from 1 st July with a closing date of 29 th September. The Code of Practice Protocol and Surrey Compact initiative recommends a three month period for applications. 9. The Working Group will meet in November in order for the Community Affairs Overview and Scrutiny Committee to receive a report in January 2007 to allow for sufficient time for the recommendations to be presented to Full Council in time for voluntary organisations can be notified in advance of the financial year 2007/08. Financial implications: Environmental implications: Legal implications: Equality Implications: To introduce a Member Working Group to consider voluntary sector funding for 2007/08. Risk Management Implications: Community Safety Implications: Background papers: Held within Community Support Services Enclosures/Appendices: Appendix A, Voluntary Sector Criteria agreed previously by the Overview and Scrutiny Committee Contact details: Melanie Bussicott, Head of Community Support Services, mbussicott@elmbridge.gov.uk Gail McKenzie, Voluntary Sector Support Officer, gmckenzie@elmbridge.gov.uk

3 APPENDIX A ELMBRIDGE BOROUGH COUNCIL APPLICATION FOR FINANCIAL ASSISTANCE VOLUNTARY ORGANISATIONS MEDIUM GRANTS 07/08 Date issued: Date returned: 1 ) Name of organisation: Registered Charity number ( if applicable ): Year formed: 2) Name and address of person to whom correspondence should be addressed: Tel no: address ( if applicable ): 3) Normal meeting/office base: If your organisation is based outside of this Borough please provide details on how it does/will deliver the service to the residents of Elmbridge: 4) Aims and objectives. (please note this information is required even if it has be supplied previously): - 34/1 -

4 5) Do you have a constitution? YES?NO (delete) If YES please enclose with application form. 6) Do you have a management committee? YES?NO (delete) If YES please provide details on a separate sheet. 7) Does your organisation operate solely within Elmbridge?: delete YES / NO If NO what percentage of your service relates to Elmbridge?: % and what area of Elmbridge does your organisation operate? 8) How many Elmbridge residents benefit from your service annually?: Please indicate age range: Please indicate, percentage wise, the gender split of residents benefiting from your service: Male % Female % Please indicate, with percentages, the racial origin of the residents benefiting from your service: White British %, Irish %, Other White % Black or Black British Black Caribbean %, Black African %, Other Black % Mixed White and Black Caribbean %, White and Black African % White and Asian %, Other Mixed % Asian or Asian British Indian %, Pakistani %, Bangladeshi %, Other Asian % Chinese or Other Ethnic Group Chinese %, Other Ethnic Group %, Don t Know % 9) Please provide the following information on staff and volunteers: a) If you employ staff how many? b) If you use volunteers how many? c) How do you recruit your volunteers? 10) Please provide details, on a separate sheet, of the purpose for which financial assistance is required and how it will help achieve your stated objectives, demonstrating relevance to Elmbridge Borough Council s key areas listed in the guidance notes. 11) Please show - a) Contribution to be made by your organisation: b) Grant required from Elmbridge B.C. (subject to a maximum of 50% of total cost ): - 34/2 -

5 12) If you have requested funding for this project from other sources please indicate: a) Which other funding bodies have you contacted and the individual amount/s requested? b) The amounts received to date/guaranteed and from whom? 13) If you have any financial reserves ( accumulated funds ): a) How much b) What, if anything, are they used for? 14) Does your organisation undertake an annual review of the effectiveness and quality of it s service? ( delete ) YES / NO. If YES please provide a copy of the last review. 15) If your request for funding is for start up costs other than a one-off building or contract works please provide a business plan. I confirm that I have no objection to this application being discussed by the Council in front of the press and public. Signed: Date: Status: All applications must be accompanied by a copy of your latest accounts. Please forward any additional information considered necessary to support this application. PLEASE RETURN TO: Gail McKenzie, Voluntary Sector Support Officer, Civic Centre, High Street, Esher, Surrey KT10 9SD ( ) - 34/3 -

6 ANNEX A The Medium Grant Award has been established for voluntary organisations seeking to claim funding of 2001 to 10,000 per annum from Elmbridge Borough Council. If you wish to apply for funding below or in excess of this amount, please request the appropriate form. The information set out below, shows the key areas that Elmbridge Borough Council considers when allocating medium grants. When completing section 10 you must demonstrate how your grant claim is relevant to as many of these key areas as you can. Effective community leadership, partnership working and involving our customers to developing our priorities Ensuring that Elmbridge is a safe, healthy and enjoyable place to live and work which is inclusive and integrates all sectors of the community. Enhancing the attractiveness and established character of our borough by taking a lead on Sustainability. Effectively managing our business to deliver high quality accessible services at an affordable cost Assisting in sustaining the varied and vibrant town centres and a strong local economy Work with our communities to enhance and protect the natural environment. Improve and develop services for vulnerable people Improve access to services Promotion of affordable housing Protect and enhance the distinctive character of the Borough Reduce level and fear of crime Attract, retain and develop high calibre staff Implementation final phase of Walton Town Centre redevelopment Open the new state of the art Leisure Centre and Pool Improve our customer focused service delivery Complete the provision of the wheeled bin recycling service to all households Delivering continuously improving, high quality services Generating social well being Partnerships and joint working Tackling social inclusion Promoting sustainable practices Maintaining the independence of older people Support to Carers Aim to provide equality of opportunity and fairness in services provided Health improvements Develop and upgrade electronic equipment Supporting young people Sustaining services for older people Improving travel and transport Promoting community safety Promoting social inclusion Managing and enhancing our natural and built environments In the last funding round 2006/07 the Council supported 42 voluntary organisations. The average amount awarded under the Small Grant was 318 and the average under the Medium was 743. The smallest amount given was 100 and the largest was 2,500 from both of the grants. - 34/4 -

7 It is strongly recommended that you request no more than 3,000 in your application. Organisations are only permitted to submit one application i.e. you can apply for funding from either the Small OR the Medium Grant Awards. Grant awards will only be given to projects designed to provide support to residents of the Borough of Elmbridge. In considering any application, the Council will have regard to existing facilities/projects of a similar nature designed to meet the same needs. In deciding the level of grant the Council will have regard to other sources of income available to your organisation. The Council only provides funding under these awards to non-profit making voluntary organisations. The Council must be satisfied that the applicant has the necessary expertise and resources to see the project through to a successful completion. If you are successful with your application, you are expected to complete a monitoring form, which will be sent to you in March. The Council advises applicants who have received a grant in the past that this does not guarantee any future commitment. Where funding is being sought on premises, please contact the Voluntary Sector Support Officer before completing the form, the Council will need to discuss lease arrangements with you. Please note, if your application is successful when applying to Elmbridge Borough Council to fund an item of equipment e.g. an office photocopier, the grant officer will need to see the proof of purchase before the grant is sent. Please note only 50% of the funding will be granted. Below shows the timescales and the process regarding the allocation of medium grants. June 06 Article released in the local press to notify that applications are available 1 st July 06 Applications available 29 th September 06 Closing date for applications November 06 Applications considered by the Voluntary Sector Funding Group 16 th January 06 Applications considered by Community Affairs Overview and Scrutiny Committee 21 st February 07 Applications ratified by full Council 1 st March 07 Voluntary organisations notified of the outcome 1 st April 07 Those voluntary organisations that are successful will receive funding as agreed by full Council All successful grants will be subject to a service level agreement produced by Elmbridge Borough Council and agreed and signed by the voluntary organisation. - 34/5 -

8 If you would like to provide additional information to support this application please feel free to do so. You maybe contacted by the Voluntary Sector Support Officer to provide further information regarding your application. Before sending your application in please check that you have enclosed a copy of: A constitution of your organisation. Details of your management committee. Purpose for which financial assistance is required. Last annual review of the effectiveness and quality of the service. A business plan. Properly audited accounts for the last year. If you have any further queries please contact the Voluntary Sector Support officer. - 34/6 -

2014/15 Patient Participation Enhanced Service Reporting

2014/15 Patient Participation Enhanced Service Reporting Practice Name: PLANE TREES GROUP PRACTICE 2014/15 Patient Participation Enhanced Service Reporting 1. Prerequisite of Enhanced Service Develop/Maintain a Patient Participation Group (PPG) Does the Practice

More information

Standard Reporting Template Patient Participation DES 2014/15. Surrey & Sussex Area Team

Standard Reporting Template Patient Participation DES 2014/15. Surrey & Sussex Area Team Standard Reporting Template Patient Participation DES 2014/15 Surrey & Sussex Area Team Practice Name Arlington Road Medical Practice Practice Code G81050 Signed on behalf of practice Dr Peter Williams

More information

Gossops Green Medical

Gossops Green Medical Gossops Green Medical Standard Reporting Template Patient Participation DES 2014/15 Surrey & Sussex Area Team Practice Name: Gossops Green Medical Practice Code: H82033 Signed on behalf of practice: Helen

More information

AYLESBURY GRAMMAR SCHOOL

AYLESBURY GRAMMAR SCHOOL AYLESBURY GRAMMAR SCHOOL APPLICATION FORM PLEASE COMPLETE USING BLACK INK OR TYPE. APPLICATION FOR THE POST OF: APP 2 - POLICE CHECK SURNAME: FORENAME(S): TITLE: ADDRESS FOR CORRESPONDENCE: POSTCODE: E-MAIL

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Swanlow Medical Centre Practice Code: N81024 Cheshire, Warrington & Wirral Area Team 2014/15 Patient Participation Enhanced Service Reporting Template

More information

Harlow Council Job Application Form

Harlow Council Job Application Form Harlow Council Job Application Form Post Applied for: Closing Date: Post Number: Interview Date: It is important that you read the guidance notes before completing this application form. Please complete

More information

Thank you for your interest in volunteering with the Avon and Somerset Constabulary.

Thank you for your interest in volunteering with the Avon and Somerset Constabulary. Human Resources Department, South Gloucestershire District Concorde House, Harlequin Office Park, Fieldfare, Emersons Green, Bristol, BS16 7FN Telephone: 0117 928 6099 Facsimile: 0117 928 6150 E-mail:

More information

Finance and Business Development Manager 21 hours per week 22,000 pro rata Actual salary 12,745

Finance and Business Development Manager 21 hours per week 22,000 pro rata Actual salary 12,745 Finance and Business Development Manager 21 hours per week 22,000 pro rata Actual salary 12,745 An exciting opportunity has arisen for finance and Business Development Manager with sound financial skills,

More information

Patient Participation Reporting Template 2014-2015

Patient Participation Reporting Template 2014-2015 Patient Participation Reporting Template 2014-2015 Practices are required to submit the patient participation report detailed below. Please submit an electronic version of this report to england.bgswareateamprimarycarebewley@nhs.net

More information

Patient Participation Reviw 2014-2015

Patient Participation Reviw 2014-2015 Patient Participation Reviw 2014-2015 Practice details: St Michaels Surgery Practice code: L81069 Stage one validate that the patient group is representative Demonstrates that the PRG is representative

More information

Degree Application Form 2015/16

Degree Application Form 2015/16 Degree Application Form 2015/16 BCME collects information about you on this form to ensure that we are fully prepared to offer you the best experience. Please complete it clearly, in black ink if possible.

More information

Living Well in Woking Small Grants Scheme 2015-2016

Living Well in Woking Small Grants Scheme 2015-2016 Living Well in Woking Small Grants Scheme 2015-2016 Please read the guidance notes carefully before completing this form If you have any questions or require this form in a different format, please contact:

More information

Medical Practice Action Plan - A Guide to PPG and Reporting

Medical Practice Action Plan - A Guide to PPG and Reporting Annex C: Standard Reporting Template Date: 25 th march 2015 Knebworth and Marymead Medical Practice Patient Participation Report 2014/15 Schedule M 1. Prerequisite of Enhanced Service Develop/Maintain

More information

Standard Reporting Template Patient Participation DES 2014/15. Surrey & Sussex Area Team

Standard Reporting Template Patient Participation DES 2014/15. Surrey & Sussex Area Team Standard Reporting Template Patient Participation DES 2014/15 Surrey & Sussex Area Team Practice Name Preston Park Surgery Practice Code G81018 Signed on behalf of practice Dr David Supple Date 27 th March

More information

JOB DESCRIPTION ASSET MANAGEMENT OFFICER

JOB DESCRIPTION ASSET MANAGEMENT OFFICER JOB DESCRIPTION ASSET MANAGEMENT OFFICER Responsible to: Asset Manager Role of Property Team The Asset Management team provides a comprehensive property maintenance service to tenants including capital

More information

AApplication for Undergraduate Studies

AApplication for Undergraduate Studies AApplication for Undergraduate Studies Admissions Office Admissions Tutor Interview Reference Decision Please complete clearly. This form will be photocopied. Please return to: Student Information Directorate

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template [Name] Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Practice Name: St Mary s Road Surgery, Practice Code: Signed on behalf of practice:

More information

Annex C Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template

Annex C Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template Practice Name: Practice Code: Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template Grey Gable Surgery Y03602 Signed on behalf of practice:

More information

If you have not heard from us by then, please consider your application unsuccessful.

If you have not heard from us by then, please consider your application unsuccessful. Governance and Executive Support Assistant Chief Executive Section Job Type: Full time 37 hours per week Location: Hull, East Yorkshire Salary: 25,000 per annum Start Date: ASAP Duration: 6 months fixed

More information

Gambling Therapist. Residential Treatment Centre for Compulsive Gamblers. 35 hours per week to include Saturdays on a rota basis

Gambling Therapist. Residential Treatment Centre for Compulsive Gamblers. 35 hours per week to include Saturdays on a rota basis Gambling Therapist Residential Treatment Centre for Compulsive Gamblers 35 hours per week to include Saturdays on a rota basis 22,945 plus OLW 1755 and 6% pension. Would you like to make a difference to

More information

Lewisham Equal Opportunities Policy Statement

Lewisham Equal Opportunities Policy Statement Torridon Infant and Nursery School Lewisham Equal Opportunities Policy Statement Lewisham Council is committed to equal opportunities both in the provision of services and as an employer. The seriousness

More information

INDIVIDUAL CABINET MEMBER DECISION MAKING

INDIVIDUAL CABINET MEMBER DECISION MAKING Agenda item: 1 Committee: INDIVIDUAL CABINET MEMBER DECISION MAKING Date of meeting: 9 th November 2006 Subject: Lead Officer: Portfolio Holder: Policy/budget ref: Exempt information: Delegated status:

More information

Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template

Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Practice Name: Harley Grove Medical Centre Practice Code: F84044 London Region North Central & East Area Team Complete and return to: england.lon-ne-claims@nhs.net no later than 31 March 2015 Signed on

More information

Patient Participation Reporting Template 2014-2015

Patient Participation Reporting Template 2014-2015 Patient Participation Reporting Template 2014-2015 Practice details: Minchinhampton Surgery Stage one validate that the patient group is representative Demonstrates that the PRG is representative by providing

More information

Annex C: Standard Reporting Template

Annex C: Standard Reporting Template Annex C: Standard Reporting Template Hertfordshire and South Midlands Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Schedule M Practice Name: Dr Fenske and Partners Practice

More information

Compliments, Comments & Complaints. This leaflet tells you how to compliment, comment or complain about our Services. www.wakefield.gov.

Compliments, Comments & Complaints. This leaflet tells you how to compliment, comment or complain about our Services. www.wakefield.gov. Compliments, Comments & Complaints This leaflet tells you how to compliment, comment or complain about our Services www.wakefield.gov.uk Comments, Compliments and Complaints We welcome your views We are

More information

LONDON BOROUGH OF LAMBETH APPLICATION FOR DISCRETIONARY RATE RELIEF

LONDON BOROUGH OF LAMBETH APPLICATION FOR DISCRETIONARY RATE RELIEF LONDON BOROUGH OF LAMBETH APPLICATION FOR DISCRETIONARY RATE RELIEF Section 47 of the Local Government Finance Act 1988 Please answer all the questions using a separate sheet if there is not enough space

More information

LOCAL PATIENT PARTICIPATION REPORT

LOCAL PATIENT PARTICIPATION REPORT LOCAL PATIENT PARTICIPATION REPORT Practice Name: Granville Medical Centre Y code: Y00918/ Redbridge 1 Establish a Patient Reference Group (PRG) comprising only of registered patients The table below reflects

More information

Draft Milton Keynes Drug and Alcohol Strategy. Consultation Paper. What is a strategy?

Draft Milton Keynes Drug and Alcohol Strategy. Consultation Paper. What is a strategy? Draft Milton Keynes Drug and Alcohol Strategy Consultation Paper What is a strategy? A strategy helps organisations such as Milton Keynes Council to plan what it needs to achieve in a specific area of

More information

Title: Mr / Mrs / Miss (Please indicate as appropriate) Other: Surname: Full forenames: Address: Post Code: E-mail: Home Tel No: Mobile Te No:

Title: Mr / Mrs / Miss (Please indicate as appropriate) Other: Surname: Full forenames: Address: Post Code: E-mail: Home Tel No: Mobile Te No: 4 Saxon House Warley Street Upminster Essex RM14 3PJ Tel: 01708 227100 Fax: 01708 250140 Application for Employment 1. Please note that Ultimate Security Services Limited is an equal opportunities employer

More information

Vacancies. Advice Workers- Edinburgh 2 Full Time (Job share might be considered) (36.25 hours a week/ 20,931 per annum )

Vacancies. Advice Workers- Edinburgh 2 Full Time (Job share might be considered) (36.25 hours a week/ 20,931 per annum ) Vacancies Advice Workers- Edinburgh 2 Full Time (Job share might be considered) (36.25 hours a week/ 20,931 per annum ) FAIR is an advice and information service for people with learning disabilities and

More information

Application for Employment

Application for Employment Principal: Stephen M Davies Application for Employment PLEASE COMPLETE ALL SECTIONS REGARDLESS OF WHETHER A CURRICULUM VITAE IS SUBMITTED Please Complete in Black Ink or Typescript POST APPLIED FOR: Personal

More information

COUNCIL TAX 2015-16. There is a statutory requirement for the Council Tax for 2015/16 to be set before 11th March 2015.

COUNCIL TAX 2015-16. There is a statutory requirement for the Council Tax for 2015/16 to be set before 11th March 2015. Agenda Item No. 10 COUNCIL - 12 FEBRUARY 2015 COUNCIL TA 2015-16 Summary The Executive has considered the draft service plans and budgets and the overall Council Tax requirement for 2015/16 and has recommended

More information

Standard Reporting Template

Standard Reporting Template Standard Reporting Template Practice Name: Dr Perkins & Partners Practice Code: L82044 Devon, Cornwall and Isles of Scilly Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Signed

More information

Personal Details Surname Surname at birth, if different Any other names by which you have been known

Personal Details Surname Surname at birth, if different Any other names by which you have been known Post applied for: Office Use Only 1 2 3 4 Personal Details Surname Surname at birth, if different Any other names by which you have been known Forenames (in full) Nationality Title (Mr, Mrs, Miss, Ms,

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Selborne Road Medical Centre Practice Code: C88083 South Yorkshire and Bassetlaw Area Team 2014/15 Patient Participation Enhanced Service Reporting Template

More information

Standard Reporting Template

Standard Reporting Template Standard Reporting Template Practice Name: Walderslade Surgery Practice Code: C85008 South Yorkshire and Bassetlaw Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Signed on

More information

VOLUNTEER CLUB LEADER TRAINING APPLICATION / ENROLMENT FORM LA: 1. Full name (given name, surname) 2. Male / Female (please circle) 3.

VOLUNTEER CLUB LEADER TRAINING APPLICATION / ENROLMENT FORM LA: 1. Full name (given name, surname) 2. Male / Female (please circle) 3. VOLUNTEER CLUB LEADER TRAINING APPLICATION / ENROLMENT FORM For SpEC office use only Number: LA: Section 1: Personal Details 1. Full name (given name, surname) 2. Male / Female (please circle) 3. Date

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Cromwell Place Surgery Practice Code: D81030 Cambridgeshire & Peterborough CCG Area Team 2014/15 Patient Participation Enhanced Service Reporting Template

More information

Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template

Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Practice Name: Ingleton Avenue Surgery Practice Code: G83024 London Region South London Area Team Complete and return to: nhscb.lon-sth-pcc@nhs.net by no later than 31 March 2015 Signed on behalf of practice:

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Dr Pidsley & Partners, Bridge Surgery Practice Code: M83042 Shropshire and Staffordshire Area Team 2014/15 Patient Participation Enhanced Service Reporting

More information

Annex C Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template

Annex C Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template Practice Name: Central Surgery Practice Code: M84023 Signed on behalf of practice: R

More information

Consultation on Proposed Changes to the Non-Residential Social Services Contributions Policy ONLINE CONSULTATION QUESTIONNAIRE

Consultation on Proposed Changes to the Non-Residential Social Services Contributions Policy ONLINE CONSULTATION QUESTIONNAIRE Consultation on Proposed Changes to the Non-Residential Social Services Contributions Policy ONLINE CONSULTATION QUESTIONNAIRE Introduction The Council are reviewing our policy about the contributions

More information

Ifield Medical Practice Local Patient Participation Report

Ifield Medical Practice Local Patient Participation Report Ifield Medical Practice Local Patient Participation Report March 2013 Practice Profile Ifield Medical Practice currently has a list size of just under 10,000 patients with the following profile: Gender

More information

Pharmaceutical Needs Assessment (PNA) Consultation Response Form

Pharmaceutical Needs Assessment (PNA) Consultation Response Form Pharmaceutical Needs Assessment (PNA) Consultation Response Form Hertfordshire Health and Wellbeing Board is consulting on the draft Hertfordshire PNA and welcome all views and comments. The consultation

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Winyates Health Centre Practice Code: M81019 [RBCCG] Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Signed on behalf of

More information

How To Be A Successful Practice Manager

How To Be A Successful Practice Manager Standard Reporting Template Practice Name: Yetminster Health Centre Practice Code: J 81017 NHS England (Wessex) 2014/15 Patient Participation Enhanced Service Reporting Template Signed on behalf of practice:

More information

Surname: Postcode: I can attend each day of the Summer School and all 16 Saturday sessions. I have completed all information in sections A, B, C and D

Surname: Postcode: I can attend each day of the Summer School and all 16 Saturday sessions. I have completed all information in sections A, B, C and D CHOICE Study with the world s leading Social Science institution Summer School: Monday 17 Friday 21 August 2015 16 Saturday Sessions: 19 September 2015 5 March 2016 Deadline Friday 20 March 2015 First

More information

I am happy for you to share my details with schools and academies

I am happy for you to share my details with schools and academies Leadership & Governance Application Form for School Governors Title: Any Previous Names: Surname: First Names: Date of Birth: Male Female Home Address (Including postcode): Work Address: (where appropriate

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Friarwood Surgery Practice Code: B87011 West Yorkshire Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Signed on behalf of

More information

DIPLOMA IN DENTAL HYGIENE AND DENTAL THERAPY APPLICATION FORM FOR ADMISSION IN Jan 2016

DIPLOMA IN DENTAL HYGIENE AND DENTAL THERAPY APPLICATION FORM FOR ADMISSION IN Jan 2016 DIPLOMA IN DENTAL HYGIENE AND DENTAL THERAPY APPLICATION FORM FOR ADMISSION IN Jan 2016 Please complete clearly in BLACK ink Use the information on the website to ensure that you complete this form correctly

More information

Standard Reporting Template Patient Participation DES 2014/15. Surrey & Sussex Area Team

Standard Reporting Template Patient Participation DES 2014/15. Surrey & Sussex Area Team Standard Reporting Template Patient Participation DES 2014/15 Surrey & Sussex Area Team Practice Name Practice Code Ash Vale Health Centre H81013 Signed on behalf of practice Jon Fox Date 30 th March 2015

More information

Standard Reporting Template

Standard Reporting Template Standard Reporting Template Practice Name: Charlton Hill Surgery Practice Code: J82025 NHS England (Wessex) 2014/15 Patient Participation Enhanced Service Reporting Template Signed on behalf of practice:

More information

SUPPLEMENTARY COURSES 2016 BOOKING FORM

SUPPLEMENTARY COURSES 2016 BOOKING FORM 2016 BOOKING FORM SECTION 1 : Course details Please complete sections 1-3 and 4 if applicable Please select from the following COURSES LOCATION DATE OPTION 1 Level 3 First Aid at Work Instructor Update

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Thames Valley Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Practice Name: Forest Health Group (previously known as Balfron Practice &

More information

Tenant transfer application

Tenant transfer application For office use Registration No. Tenant transfer application Main applicant Place passport sized photo of main applicant here Place passport sized photo of joint applicant here If you would like any part

More information

The CILEx Compensation Fund Claims Application Form

The CILEx Compensation Fund Claims Application Form The CILEx Compensation Fund Claims Application Form Please complete this form to make a claim for a loss you have incurred. When you have filled in the form, please send it to us at: The CILEx Compensation

More information

Compensation for a personal injury following a period of abuse (physical and/or sexual)

Compensation for a personal injury following a period of abuse (physical and/or sexual) Criminal Injuries Compensation Authority Tay House 300 Bath Street Glasgow, G2 4LN Freephone: 0800 358 3601 For office use only Reference number: Compensation for a personal injury following a period of

More information

Referral Form. What benefits does the applicant receive? allocated?

Referral Form. What benefits does the applicant receive? allocated? Please return to Christopher Davies Heantun Housing Association 3 Wellington Road Bilston West Midlands WV14 6AA 01902 571131 christopher.davies@heantun.co.uk Referral Form Personal details: Name of applicant:

More information

Project Manager s Introduction

Project Manager s Introduction Dear prospective volunteers, Project Manager s Introduction It is fantastic that you are interested in helping us support young and vulnerable people in Cheshire. Nightstop is a way of volunteering from

More information

Please complete in Black ink and write legibly, in capital letters if necessary.

Please complete in Black ink and write legibly, in capital letters if necessary. Lisa Edwards Hair and Skincare / Edwards for Men Application Form Please return to: Lisa Edwards Chichester 68, North Street, Chichester, Po19 1lp Or Email to: Chichester@lisaedwards.co.uk Position Applied

More information

Annex C: Standard Reporting Template

Annex C: Standard Reporting Template Annex C: Standard Reporting Template Practice Name: The Hedges Medical Centre Practice Code: C82100 Leicestershire and Lincolnshire Area Team 2014/15 Patient Participation Enhanced Service Reporting Template

More information

62 BATTLE ROAD ERITH, KENT DA8 1BJ TEL: 01322 432997 Fax: 01322 442324 DR K S NANDRA

62 BATTLE ROAD ERITH, KENT DA8 1BJ TEL: 01322 432997 Fax: 01322 442324 DR K S NANDRA 62 BATTLE ROAD ERITH, KENT DA8 1BJ TEL: 01322 432997 Fax: 01322 442324 DR K S NANDRA Patient Participation Group Report March 2013 The Bulbanks Medical Centre Patient Participation Group currently has

More information

Individual Application Form

Individual Application Form Individual Application Form Bar Pro Bono Unit, National Pro Bono Centre, 48 Chancery Lane, London, WC2A 1JF DX 188 London Chancery Lane Email: enquiries@barprobono.org.uk; Tel: 020 7092 3960 (Mon, Wed

More information

SIGHT FOR SURREY - APPLICATION FOR SUPPORT

SIGHT FOR SURREY - APPLICATION FOR SUPPORT Agenda Item No. 23 EXECUTIVE 10 DECEMBER 2015 Executive Summary SIGHT FOR SURREY - APPLICATION FOR SUPPORT The Surrey Association for Visual Impairment works under the name of Sight for Surrey. Sight for

More information

APPLICATION FORM. Right Guard Security UK Ltd act as Managing Agents for Payroll Workshop Ltd to manage their employees on their behalf.

APPLICATION FORM. Right Guard Security UK Ltd act as Managing Agents for Payroll Workshop Ltd to manage their employees on their behalf. APPLICATION FORM Right Guard Security UK Ltd is an expanding company that has a vast range of security services. We are dedicated to providing an excellent service through highly trained, loyal and committed

More information

STREATHAM HIGH PRACTICE

STREATHAM HIGH PRACTICE STREATHAM HIGH PRACTICE PRG LOCAL PATIENT PARTICIPATION REPORT & ACTION PLAN (In agreement with Patient Representative Group - PRG) 2013-14 Page 1 of 24 Local Patient Participation Report Contents: Streatham

More information

CHARTERED BANKER MBA. Application Form BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION. www.charteredbankermba.co.uk

CHARTERED BANKER MBA. Application Form BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION. www.charteredbankermba.co.uk BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION CHARTERED BANKER MBA TM Application Form www.charteredbankermba.co.uk Notes on Completing the Application Form Please read the notes below before completing

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Dr Hill and Partners Practice Code: B81042 North Yorkshire and Humber Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Signed

More information

National Gardens Scheme Head of Marketing. Appointment Brief. August 2012 REF: YAANB

National Gardens Scheme Head of Marketing. Appointment Brief. August 2012 REF: YAANB National Gardens Scheme Head of Marketing Appointment Brief August 2012 REF: YAANB The organisation What the National Gardens Scheme does The National Gardens Scheme (NGS) is a registered charity (No.

More information

Three Rivers Housing Association Customer Survey

Three Rivers Housing Association Customer Survey Three Rivers Housing Association Customer Survey Q1. Address Q2. Postcode Tenancy Ref (if known) Q3. Daytime Phone Number Q4. Evening Phone Number Q5. Mobile Phone Number Q6. Do you have internet access?

More information

About Only Connect - A Guide to Successful Review of the applicant Application

About Only Connect - A Guide to Successful Review of the applicant Application Support Manager, OC Central Section 1: Information for Applicants Section 2: About Only Connect Section 3: About the Role Section 4: Monitoring Form 1 SECTION 1: INFORMATION FOR APPLICANTS The following

More information

APPLICATION FORM AND GUIDANCE NOTES

APPLICATION FORM AND GUIDANCE NOTES APPLICATION FORM AND GUIDANCE NOTES Application to Register for a teacher who is recognised as a qualified teacher by a member state of the EU, EEA or Switzerland and is seeking recognition under EU Directive

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: SPITAL SURGERY Practice Code: N85617 Cheshire, Warrington & Wirral Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Signed

More information

Standard Reporting Template

Standard Reporting Template Standard Reporting Template Practice Name: Lockswood Surgery Practice Code: J 82174 NHS England (Wessex) 2014/15 Patient Participation Enhanced Service Reporting Template Signed on behalf of practice:

More information

EQUALITY IMPACT ASSESSMENT AND ANALYSIS (EqIAA) Direct Payment: Payment Cards

EQUALITY IMPACT ASSESSMENT AND ANALYSIS (EqIAA) Direct Payment: Payment Cards EQUALITY IMPACT ASSESSMENT AND ANALYSIS (EqIAA) Direct Payment: Payment Cards SECTION 1 - INTRODUCTION This EqIAA covers the issue of whether a payment card solution for the delivery of direct payments

More information

Annex D: Standard Reporting Template

Annex D: Standard Reporting Template Annex D: Standard Reporting Template Practice Name: Stanley Court Surgery Practice Code: N84611 Lancashire Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Completed by: Lesley

More information

Code of Corporate Governance

Code of Corporate Governance www.surreycc.gov.uk Making Surrey a better place Code of Corporate Governance October 2013 1 This page is intentionally blank 2 CONTENTS PAGE Commitment to good governance 4 Good governance principles

More information

Mental Health Acute Inpatient Service Users Survey Questionnaire

Mental Health Acute Inpatient Service Users Survey Questionnaire Mental Health Acute Inpatient Service Users Survey Questionnaire What is the survey about? This survey is about your recent stay in hospital for your mental health. Who should complete the questionnaire?

More information

Annex C: Standard Reporting Template

Annex C: Standard Reporting Template Annex C: Standard Reporting Template Hertfordshire and South Midlands Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Schedule M Practice Name: Parkfield Medical Centre Practice

More information

Annex C: Standard Reporting Template

Annex C: Standard Reporting Template Annex C: Standard Reporting Template Practice Name: Marsh Medical Practice Practice Code: C83042 Leicestershire and Lincolnshire Area Team 2014/15 Patient Participation Enhanced Service Reporting Template

More information

FULL-TIME APPLICATION FORM

FULL-TIME APPLICATION FORM Learner Number: FULL-TIME APPLICATION FORM St Peters Street Lowestoft Suffolk NR32 2NB Telephone: 01502 583521 Fax: 01502 500031 Email: info@lowestoft.ac.uk www.lowestoft.ac.uk 1 st choice course 2 nd

More information

Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template

Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template London Region North Central & East Area Team Complete and return to: england.lon-ne-claims@nhs.net no later than 31 March 2015 Practice Name: Islington Central Medical Centre Practice Code: F83010 Signed

More information

SPECIALIST TENANCIES MANAGER PERSON SPECIFICATION

SPECIALIST TENANCIES MANAGER PERSON SPECIFICATION SPECIALIST TENANCIES MANAGER PERSON SPECIFICATION The Selection Panel has identified this comprehensive specification for the ideal candidate and will use this to examine the internal candidate(s) who

More information

PROPERTY INFORMATION FORM

PROPERTY INFORMATION FORM PROPERTY INFORMATION FORM SCHEME: To: HELP TO BUY Help to Buy East & South East, bpha limited, Bedford Heights, Manton Lane, Bedford, MK41 7BJ (the Help to Buy Agent) as agent for Homes and Communities

More information

Standard Reporting Template

Standard Reporting Template Standard Reporting Template Practice Name: Southernhay House Surgery Practice Code: L83058 Devon, Cornwall and Isles of Scilly Area Team 2014/15 Patient Participation Enhanced Service Reporting Template

More information

The Streatfield Medical Centre - Patient Participation Groups

The Streatfield Medical Centre - Patient Participation Groups Annex D: Standard Reporting Template Practice Name: The Streatfield Medical Centre Practice Code: E84646 NW london Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Signed on

More information

Capita HR Solutions. HR Services Director

Capita HR Solutions. HR Services Director Capita HR Solutions HR Services Director August 2013 Contents The Company... 3 Job Description... 4 The Rewards... 6 Advertisement... 7 How to Apply... 8 Equality & Diversity Monitoring form... 9 Capita

More information

Supporting People Delivery of Assistive Technology Monitoring Services

Supporting People Delivery of Assistive Technology Monitoring Services Agenda Item No 13 Bolsover District Council Executive 1 December 2014 Supporting People Delivery of Assistive Technology Monitoring Services Report of the Cllr K Reid, Portfolio Holder for Housing This

More information

job pack www.creative-bridge.com

job pack www.creative-bridge.com job pack November 2015 Customer Service Executive Welcome Hello, and welcome to Creative Bridge. We re looking for an enthusiastic, driven and reliable Customer Service Executive who is excited at the

More information

Standard Reporting Template

Standard Reporting Template Standard Reporting Template Bristol, North Somerset, Somerset and South Gloucestershire Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Practice Name: Practice Code: Cannington

More information

Job Application form

Job Application form Job Application form Post Applied for: Closing Date: form Job Reference: form Please complete this form in black ink. Applications received after the closing date will not normally be considered. THE INFORMATION

More information

LAMDA Postgraduate Diplomas Application Form Entry 2016

LAMDA Postgraduate Diplomas Application Form Entry 2016 Attach small recent photo here Do not send 10 x 8 photo LAMDA Postgraduate Diplomas Application Form Entry 2016 Please note you can apply on-line www.lamda.org.uk Please enclose an Interview fee (non-returnable)

More information

Application form for employment

Application form for employment Position: Ref no: (For office use only) Thank you for your interest in employment with Eden Project Ltd. Please complete this application form in as much detail as possible. We will be using the information

More information

Application Form Trainee Solicitors

Application Form Trainee Solicitors Application Form Trainee Solicitors Year for Commencement of Training Contract/Graduate Placement Week: Personal Details Name (in full): Mr / Mrs / Miss / Ms (delete as appropriate) Mobile number: Email:

More information

TEACHER APPLICATION FORM

TEACHER APPLICATION FORM TEACHER APPLICATION FORM Please note this post involves working with children or vulnerable adults so appointment will be subject a Criminal Records Bureau disclosure. See supporting information for further

More information

Standard Reporting Template

Standard Reporting Template Standard Reporting Template Practice Name: Stillmoor House Medical Practice Practice Code: L82010 Devon, Cornwall and Isles of Scilly Area Team 2014/15 Patient Participation Enhanced Service Reporting

More information

Annex C Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template

Annex C Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template Practice Name: Practice Code: Arden, Herefordshire and Worcestershire Area Team Patient Participation Enhanced Service 2014/15 Reporting Template Moorfield House Surgery M81026 Signed on behalf of practice:

More information

Application Form Foundation Degree in Business 2 years Full-Time (Part-Time attendance)

Application Form Foundation Degree in Business 2 years Full-Time (Part-Time attendance) Application Form Foundation Degree in Business 2 years Full-Time (Part-Time attendance) Please read the online course leaflet page for details of the entry requirements. Personal Details Surname First

More information

Business Applications - Part Time Maternity Cover ( HPV)

Business Applications - Part Time Maternity Cover ( HPV) Marketing Manager (part time) Maternity Cover Dear Applicant Thank you for your interest in this post. Bridport Arts Centre is housed in a Grade 2 listed Wesleyan Chapel and adjoining schoolroom. It consists

More information