Application for Lifelong Learning Grant

Name

Address

Telephone

Email

BAOT Membership No.

Work Address

Title of Course/ Activity

Date

Course Content/ Description

Please advise the date when you need a funding decision by:Cost (must not include. Travel/subsistence)Funding required(Max £150)Relevance to practice with reference to how this will benefit:

1. your clients2. yourself3. your employer4. the profession and society

(Madden & Mitchell 1993)(approx 500 words)

Registered Office: 106-114 Borough High Street, Southwark, London SE1 1LBTelephone: 020 7357 6480 Fax: 020 7450 2299 www.cot.org.uk

College of Occupational Therapists Ltd. Reg. in England No. 1347374 Reg. Charity No. 275119 VAT Reg. No. 242 7829 47

DISSEMINATION OF FINDINGS.The Grant is conditional on the applicant providing a report/Article for the regional ‘Engage’ newsletter within four weeks of the event. (500 words minimum).

Signature: Date:

Outcome: - Agreed Not Agreed