Living Transplant Initiative (LTI)

Pro-forma for submitting bids

Please refer to the Invitation to Bid document before completing your application.

Deadline for receipt of applications is 8 August 2018.

SECTION 1 – APPLICANT DETAILS

  1. Organisation name:
  1. Main Contact:

Address of Organisation
Contact Name
Position in Organisation
Contact Tel Number(s)
Email
Website
  1. Partners: If you are applying on behalf of more than one organisation, please tell us why you have chosen to work more closely with this / these particular partner(s) and what track record you have of working together with them. Please list the other organisations and confirm that they have approved this application.
  1. Status: What type of organisation are you? (Please delete Yes / No as relevant). If you are applying with partners, please provide the following details for them too.

Registered Charity Yes / No Number …………………………..
Company Limited by guarantee Yes / NoNumber:
Charitable Incorporated Organisation Yes / No Number …………………………..
Community Interest Company Yes/ NoNumber …………………………..
Unincorporated Group Yes / No Registered Society Yes / No
Other (please specify)………………………..…………………………..……………

SECTION 2 – PROJECT PROPOSAL

  1. Title of your project.
  1. Summary of proposed project (not more than 200 words)
  1. Purpose of proposed project (not more than 200 words)
  1. What will your contribution be towards the three key targets for 2018/19 set out in section 3 of the Invitation to Bid document (not more than 200 words)
  1. Indicate the timescales and milestones to be achievedover the period of the project (not more than 200 words)
  1. Short account of previous work with a BAME community related to organ donation (not more than200 words)
  1. Please set out the membership of your project planning group and how it will work.
  1. Please outline the dissemination plan for your project upon completion (not more than 200 words)

Section 3: budget

1.What is the total cost of this Project (this must not exceed £3K)?

2.Are you requesting funds or support from anywhere else? If so, please provide details.

  1. Please provide detailed justification for support requested: major expense items are essential, particularly justification of salaries.

4.Budget breakdown summary (incl. VAT). Please provide a full breakdown of costs.

Type of Cost
e.g. staff costs, publicity, venue hire, travel, consultancy fees and management costs / Total Project Cost / Amount Requested / Details / Cost Breakdown
Total
  1. Signature of applicant
  1. Date:

Please send your completed application to by 8 August 2018.

Further details about NBTA are available at

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