Application for EOPD.ie Community Grant

JobJobRequire for hubspot. We cannot delete the field

First NamePlease enter your first name exactly how you want it to appear in all correspondence, proposals and awards.

Last NamePlease enter your last name exactly how you want it to appear in all correspondence, proposals and awards.

Email Address *

Date application completed

Mobile *

Street Address

Town/City

County

Eircode / Postal Code

Country

Project Details

Project name

Have you engaged a person with living Parkinson's in the planning of your program?YesNo

Have you run a pilot program of these activities?YesNo

If no (to the above), is the proposed program intended to be a pilot?YesNo

Are you replicating a program offered elsewhere?YesNo

How would the receipt of the grant benefit people with EOPD and PD? Such as, would the receipt of the grant impact the cost of the service or the availability of the service?

Other Funding Sources

Will this program receive funding from another organization or grant?YesNo

If yes, please describe where the funding will come from, how much it will be for, and what the funding would cover.

What is your organization's plan to support this program outside of/beyond this grant period?

Project Period

Proposed start date of your program

Proposed end date of your program

How much are you applying for?Please note that the maximum amount is €1,200

Please upload some informational content about your activity

No file chosen

Posters and brochures explaining your acitivity

Please upload file with a breakdown of your activities costs

No file chosen

Please also include any documents of other funding sources

If you have any questions or queries, please email info@eopd.ie

Project Details

Other Funding Sources

Project Period

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EOPD - Early Onset Parkinson's Disease in Ireland