Project Name

Lead Name

Email address

Number of Volunteers

Number of Beneficiaries to date

Project Description and Objectives

Annual Budget? How much of this is statutory funding?

Working in partnership (cross-sector)

Case Study

Project specific outcomes

Contribution to policy agenda e.g. Every Child Matters outcomes

Please indicate whether you are contributing to any of the following outcomes: (Outcomes taken from the Outcomes Framework for Performance Assessment of Adult Social Care )

Please choose (if you have more than one choice please use the space below to indicate other/s)

1. Health & Emotional Wellbeing
2. Quality of life
3. Making a positive contribution
4. Exercising choice & control
5. Freedom from discrimination & harassment
6. Economic wellbeing
7. Personal dignity & Respect

Any additional information