Application form – Engagement Grant

Name:

Organisation:

Contact address:

Telephone:

Email:

How did you hear about this grant?:

Project Title:

Who are you aiming to reach with your activity?:

Why are you engaging this public audience?:

What do you want participants to take away from your activity?:

When and Where will you engage the public?:

How will you achieve your aim(s) through developing this idea?:

What is your project timeline? (please provide details for key timepoints in the project planning and delivery):

How will you promote your activity with your target audience?:

How will you evaluate whether you have achieved your aim(s)?:

What experience/background do you have which is relevant to your grant proposal?:

How does your project align with the vision of the British Pharmacological Society and what potential benefits are there for the BPS? :

How will you disseminate your activity to members of the BPS?:

Are you seeking sponsorship from any other sources? If so, please give details:

Total project cost (please give full details of expenditure and justification for resources requested):

Total amount sought from the Society:

Please give details as to whether there are plans to commercialise this work:

Security code:

Enter security code: