Grant Application Form

To apply for a Barts Guild grant, please complete this form and when ready click the ‘SUBMIT’ button once. You can attach up to three documents in support of your application.

PLEASE NOTE that the form cannot be saved and returned to at a later date; therefore it must be completed and submitted in one session.

Please familiarise yourself with the Barts Guild Grants Policy before applying.

* indicates a mandatory field

    ABOUT YOU

     
    Title*

    Given Name*

    Family Name*

    Job Title*

    Department*

    Work Address*

    Tel. (work)*

    Tel. (mobile)

    Email address*

     

    YOUR APPLICATION

     
    Grant Title*

    Please explain what this grant will be used for.*

    What will be the impact of this grant for the Hospital and its patients?*

    Amount Requested (please provide a breakdown of costs, if relevant):*

    Will VAT be added to this amount?*
    YesNoNot Applicable

    Is this the full cost of the item/service? Please also consider associated costs such as delivery and installation, where applicable.*
    YesNo

    Does this grant relate to an item or items that will require on-going maintenance and/or consumables?*
    YesNo

    If applicable, has authorisation been given to submit this application by a senior, e.g. line manager/ward manager/supervisor?* This is necessary for education grants, as outlined in our Grants Policy
    YesNo

    Please provide the date(s) of the event, course or conference, if applicable, for which financial support is being sought, and also provide any additional information to accompany your application such as a website link to the product or service for which a grant is requested.

    If you would like to attach any documentation in support of your application, please do so using the buttons below. You can attach up to three documents.



    PERSONAL DATA
    The Guild is committed to protecting your privacy. Please tick the box to confirm that you consent for the Guild to process your personal data in accordance with our