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Applicant Details:

First name: Last Name:

Date of Birth (dd/mm/yyyy):

Contact Telephone Number:

Alternative Contact number:

Email Address:

Your Address:

Postcode:

Name of Project:

About your project:

How many people will coordinate / lead on the project including yourself?:

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How many young people are you aiming to engage in your project?:

Will anyone else benefit from your project?:

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Please tell us about what your project is and the difference it will make to young people in your community. It is important to give as much detail as possible.

What is your idea?:

Why do you feel that there is a need for this project?:

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What is unique about it? (in 140 characters or less):

Where will it take place?:

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Describe the project activity in more detail (think about the main steps you want to achieve):

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What lasting benefit do you feel that your project will have on your community and the young people in it?:

What is your project timeline? If your application is successful how long will it take to get your project up and running?What preparation / lead-in time do you need? (Please note if you are successful, funding will not be available until June 2014):

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Have you thought about any possible risks that might be involved in your project and how would you overcome them?:

BudgetSYA provide two levels of funding of up to £1,500 and up to £2000.

What is the total project budget?:

What amount are you requesting from SYA?:

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In order for us to get a clearer idea on how your project will work and how the funding will support you, please complete this budget sheet where you will need to demonstrate what you will use your funding for and how it will fit into ensuring the success of your project. Please note we will not pay for staff costs. If your project costs more than we can fund, you will need to show us where else will you be getting the additional funding or support from.

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Tell us more about what else you need to make your project happen, other than funding e.g. volunteers, refreshments, venue, insurance:

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Item - (eg venue hire) Use headingsthat best describe the activity

Cost Amount soughtthrough YouthAction funding

Amount to be funded from other sourcesNon-Youth Action source -eg, own funding, local authority.

Have you secured otherfunding needed? If notwhen do you hope tohave this by?

£/€ £/€

£/€ £/€

£/€ £/€

If you are under 18 years old, please provide details of an adult supporting the project: (this can be a family member)

Name:

Email address:

Contact Telephone Number:

If you are part of a youth group / school / college please share details below:

Contact details for that organisation:

Name:

Lead worker:

Email Address:

Contact Telephone Number:

Please sign below to confirm that this application is your own idea and that you will be happy to feature in promotion of Starbucks Youth Action

Signed: Date:

Please submit your application to starbucksyouthaction@ukyouth.org

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