June Baker Trust

Grants for emerging conservatorsin Scotland

2016Application Form

Please read the Guidance for Applicants before attempting to complete the form.

Please complete the form electronically using the boxes provided. You must answer all the questions and include everything you want to tell us in the form. Do not include hyperlinks or append supplementary information.

SECTION 1: About you

1.1.Your name.

1.2.Your e-mail address.

(Please note we will correspond with you electronically at this address)

1.3.Your address.

(Please note this will be the address we will use for financial purposes)

1.4.Your telephone number(s).

1.5.Names and addresses of two referees.

1.6.Your connection with Scotland. (Please mark X in the box for all that apply.)

I live and work in Scotland now
I was born in Scotland
I attended school in Scotland
I attended university in Scotland
My conservation qualification is from a Scottish institution
The majority of my conservation work experience to date has been in Scotland
My career plan is to work as a conservator in Scotland
I have another connection to Scotland (please specify below)

1.7.Name of the institution where you gained your conservation qualification.

1.8.The qualification you gained and date you qualified.

1.9.Please tell us in no more than 100 words a little about the content of the course.

1.10.Please list your work experience in conservation to date (most recent first), including any placements undertaken during your course and any voluntary experience. (Please add or delete rows as required.)

Dates (from…to…) / Name of organisation / Supervisor’s name and job title / How you were ‘employed’?(Pick from employee/intern/volunteer/ placement/contractor/other)

1.11.Pleaseprovide up tofive examples of projects or activities you consider to be your key conservation achievements so far, and in no more than 50 words, tell us what you learned through the process.

Experience: / Learning points (50 words max)
Example 1
Example 2
Example 3
Example 4
Example 5

1.12.Please tell us in no more than 100 words about the conservation work you are doing now.

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SECTION 2: About your plan

2.1. Please summarise in no more than 100 words the learning and development plan which is the subject of this application.

2.2.Please list then briefly describe each of the activities that make up your learning and development plan and show which of the June Baker Trust’s objectives for the scheme it supports.(One activity per row please – add rows as required. Objectives can be found in the Guidance.)

Activity / Description of the Activity / Which JBT objective(s) does it support?

2.3.Please provide a timetable for your planned learningand development activities.

The activity you plan to do / When you plan to do it

2.4.Please tell ushow your own learning and development will benefit as a result of each of your planned activities.(One activity per row please – add rows as required.)

Activity / How will this activity support your own learning and development?

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SECTION 3: What your plan will cost

3.1. What is the total cost of your plan?

£

3.2.Please provide a breakdown of costs. (Please addrows as required.)

Item / The Activity it relates to / Cost

3.3. Please tell us here if you have any other sources of funding for any of your planned activities.

3.4. How much are you asking the June Baker Trust for?

£

3.5. In case the June Baker Trust is unable to support all the activities in your plan, please rank your activities in order of their importance to you.

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SECTION 4: Terms of grant and declaration

You must agree to the terms of grant and complete the declaration below for your application to be eligible.

Terms of grant

You must use the grant only for the activities set out in your learning plan andas agreed by the June Baker Trust in our offer letter. (These will be set out in the letter).

You must confirm acceptance of the grant as offered within one month of the offer being made.

You must declare any other sources of funding you expect to receive for actions or activities which are in your plan. You must also notify the June Baker Trust if for any reason you secure funding for a part of your plan after you have started it, and reimburse us for that component (see Section 6 of the Guidance for Applicants).

The June Baker Trust cannot increase the grant if the cost of the agreed plan increases.

Should you need to adjust the specific actions under an activity, you must ensure that any changescontinue to deliver the outcomes of that activity (as set out in the application and agreed in the offer letter).

If you fail to start your learning plan within your stated timescale you must return the grant in full.

You must report on the implementation of your learning plan within one month of completing it, using the template we will provide when a grant is awarded.

The June Baker Trust has the right to ask you to submit any receipts for costs incurred. You must retain all receipts until after we have accepted your report.

Declaration

I confirm that the information in this application is correct to the best of my knowledge and that I have read and understood the terms of grant.

Name:

Date:

To submit your completed application, please e-mail it as an attachment to: .

Closing date for applications: 8th February 2016.

Your application will be acknowledged and you should expect to hear if you have been successful by mid May 2016.