2017-2018

Cwm Taf Crystal Trophy Awards

Application Form

Name of Project/

Activity


Contact Person

Group/Organisation

Postal Address

Post Code

Telephone

Mobile No

Email

Please tick relevant status of your group (tick all boxes which apply)

Community Group ☐ / Communities First Partnership ☐
Registered Charity ☐ / Local Voluntary Group ☐
Other ☐ Please give more information here

Are you a member of a Cwm Taf Voluntary Council?

Interlink (Rhondda Cynon Taf) / Yes ☐ / No ☐
Voluntary Action Merthyr Tydfil (VAMT) / Yes ☐ / No ☐
Tell us about your project (your application will be scored on this section)
Aim: What is the project about and what is it trying to achieve?
Click here to enter text.
Need: How do you know this project is necessary in your area? What research or evidence do you have?
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How does your project contribute to healthy lifestyles and the prevention of ill health?
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Impact: What difference does your project make to its beneficiaries? What evidence do you have of this?
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What is unique about your project?
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How long has your project been running? / Click here to enter text.
How many people have benefitted from the project since it began? / Click here to enter text.
Do you have volunteers involved? / Yes ☐ No ☐
If Yes, how many volunteers are involved? / Click here to enter text.
In delivering this project do you connect with any other groups or organisations?
If Yes, name them below:
(We may need to contact your partners for information) / Yes ☐ No ☐
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Tell us about the funding for the project (projects funded by Local Authorities; Health Board or Public Health Wales are not eligible to apply).
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In terms of health & safety how do you operate safely?
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Has the project/activity been evaluated or monitored?
Internally / Yes ☐ No ☐
Externally / Yes ☐ No ☐
Not Evaluated/monitored ☐
Details:
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If you won the Crystal Trophy Award how would you develop or enhance your project? (We will contact you in 6 months to see how your project has developed)
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Closing Date for Applications: 13th April 2018

Submit via email placing “Crystal Trophy” in the subject box to:

or

or submit via post and mark your envelope “Crystal Trophy” to:

Anne MorrisSharon Richards

InterlinkVoluntary Action Merthyr Tydfil

6 Melin Corrwg89-90 High Street

Cardiff RoadPontmorlais

Pontypridd CF37 5BEMerthyr Tydfil CF47 8UH

NB: please ensure you obtain an acknowledgement of receipt of application, and ensure it is received before the deadline.

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