Achievement Awards Application - Youth Organisations

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Contact Details

Title

First Name

Last Name

Your Job Title within the Organisation

E.g. Centre Manager, Admin

Your Email address

Your contact telephone number

Enter as follows; Area code / local number (e.g. 0208 2528000)

Address Line 1

Address Line 2

Town

County

Post Code

Organisation Details

Name of Organisation

CEO / Director / Chairperson Title

This should be the most senior person within your organisation

CEO / Director / Chairperson's First Name

This should be the most senior person within your organisation

CEO / Director / Chairperson's Last Name

This should be the most senior person within your organisation

CEO / Director / Chairperson's email address

This should be the most senior person within your organisation

Organisation's telephone number

Organisation's website address

e.g. www.jackpetcheyfoundation.org.uk

Address Line 1

Address Line 2

Town

County

Post Code

Select your Borough or District

Which London Borough or Essex District is your establishment in?

Multiple Boroughs / Districts

If your Organisation covers multiple Boroughs / Districts please check this box

Organisation Details

Which year was your organisation established

Organisation type

Please provide the Registered Charity Number

Other type

Please provide details

Attendees aged 11-25 at your organisation?

Does your organisation have an Equal Opportunities Policy

YesNo

Does your organisation have a Child Protection Policy

YesNo

Does your organisation have Public Liability Insurance

YesNo

Does your organisation have signed and dated Constitution or Memorandum & Articles of Association with a dissolution clause

YesNo

How many staff do you have?

Employees

Volunteers

Finances

Does your organisation have a bank account in its own name that requires two signatories?

YesNo

Please tell us about your finances for the last 12 months

Income

Expenditure

Unrestricted Reserves

Has your organisation received funding from us before?

YesNo

Application Details

Please tell us how you found out about the Jack Petchey Foundation and the Achievement Award scheme

Other Details

As you selected 'Other' from the above options, please provide further details. Please use no more than 50 words

What are the aims and objectives of your organisation?

Please use no more than 500 words

What services do you offer to young people and tell us about the opportunities you provide to develop young people?

Please use no more than 500 words

How frequently do you meet your young people and for how long?

Please use no more than 500 words

Please describe your organisation's management structure

Please use no more than 500 words

Please tell us how the Achievement Award scheme will enhance your ability to recognise and value the achievements of young people within your organisation

No more than 500 words

Referee Details

You must provide an independent referee. This should be someone with professional experience of the work you do with young people e.g. a teacher, social or youth worker, or a police officer. The referee must know you and your organisation and be able to recommend your application. Their professional email and telephone should be provided.

Title

Referee's first name

Referee's last name

Referee's Job Title

E.g. Deputy Head, Secretary, Head of Year

Address Line 1

Address Line 2

Town

County

Post Code

Referee's work telephone number

Referee's mobile number

Referee's work email address

Referee's connection to your organisation

Terms & Conditions

Information provided for applications cannot be held confidentially.

The Jack Petchey Foundation will always keep any personal information you provide private and secure. However, we may share data about the operation of JPF with the Foundation’s auditors, Sayer Vincent, as well as with HMRC, the Charity Commission, the Information Commissioner’s Office, Companies House, and other regulatory bodies if necessary to meet statutory audit and regulatory requirements.

From time to time the Jack Petchey Foundation shares applicant information with other funders, our PR agency and third parties for the furtherance of JPF activities. JPF will usually contact applicants before disclosure is made, but this cannot be guaranteed.

If your application is successful, you are required to provide:

1. Your latest signed approved accounts (i.e. accounts signed by your Trustees and Auditors if relevant)

2. Your Constitution or Memorandum & Articles of Association (signed and dated)

3. An original copy of a recent bank statement (dated within last 3 months) showing account name, account number and sort code.

Tick this box to tell us that:

1. The information that you have given on this form is true and accurate and that you agree with the above.

2. The Chairperson of your organisation is aware that this application is being submitted on behalf of your organisation

Yes

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