Capacitybuilders case study capture form

1. Your details

First name

Surname

Job title

Organisation

Infrastructure organisation type
Select one Local Regional National Other

Email address

Phone

2. Case study 1 contact
if different to your details

First name *

Surname *

Job title *

Organisation *

Infrastructure organisation type *
Select one Local Regional National Other

Email address *

Phone *

3. Case study 1 - Topic

4. Case study 1 - Brief summary

Include the difference the project has made and quantify the benefits if you can.

5. Case study 1 - Capacitybuilders/ChangeUp grant details

Programme grant awarded through, date of award and amount.

6. Case study 1 - Quote

Are quotes available from service users/frontline beneficiaries?
Yes   Maybe   No   Don’t know

If yes or maybe, please provide details *

7. Case study 1 - Photo opportunities

Are there possible photo opportunities?
Yes   Maybe   No   Don’t know

If yes or maybe, please provide details *

8. Case study 1 - Existing photography

Is there existing photography we might be able to use?
Yes   Maybe   No   Don’t know

If yes or maybe, please provide details *

9. Case study 1 - Key areas

Which of the following key areas does the case study match?  Select one or more.
 Finance
 Governance
 ICT
 Performance
 Volunteering
 Workforce

10. Case study 1 - Region

Select one National North East Yorks & Humber East of England East Midlands West Midlands North West London South East South West

11. Case study 1 - Is there an existing case study?

Yes   No

If yes, select one of the options below *

12. Case study 1 - Anything else?

Is there anything else we should know?  E.g. copyright restrictions, credits, etc. *

13. Do you have another case study you would like to tell us about.

Yes   No