zilongwang/ReadingBank huggingface dataset:
To be submitted for Commission approval prior to the implementation of a new baccalaureate degree program. In addition, please note: A related degree program is defined as related to the approved degree program(s) currently offered by each school listed School # School Name Type City State Degree Granting Main: Yes: Branch: No: Contact Person Phone Email Program Title (e.g. Business Administration) Type of Program One) Length of Program (in Months) Full Credential & Abbreviation Proposed Start Date Related Unrelated Course Distribution (Must match the Outline of a Degree Program form) Standards Semester/ Quarter Credit Hour Requirements Credit Hours Externship Information (Externship hours as listed on the Outline of a Degree Program; may include multiple courses) Semester Credit Hours Quarter Credit Hours Technical/Occupational 60/90 Total Externship Clock Hours: General Education 30/45 Other 0/0 Total Externship Credit Hours: Total 120/180 I certify that the information herein and attached hereto is correct and that this degree program has not been described in the catalog, advertised or offered to students. Name Signature Title Date ELECTRONIC SUBMISSION FORMAT REQUIREMENTS: Electronic Submissions may not be transmitted to the Commission via e-mail. The school’s response must be prepared in accordance with ACCSC’s (e.g., prepared as one Portable Document Format (“PDF”) file that has been prepared using Adobe Acrobat software (version 8.0 or higher) and which has a .pdf extension as part of the file name). The school will receive an e-mail confirmation that the file has been received within 24 hours of the submission. ACCSC has issued the Blueprints for Success Series: . ACCSC encourages the school to review this module prior to submitting this application. More information is available under the at .
APPLICATION FOR APPROVAL OF GAMING MACHINES AND PERIPHERAL EQUIPMENT If insufficient space is available for responses please attach additional information. SECTION 1 - Details of Applicant An approved Supplier may apply for approval of a gaming machine or peripheral equipment. Name of Supplier (enter text) Certificate Number (enter text) Postal address (enter text) Contact Person (enter text) Telephone (enter text) Facsimile (enter text) Email Address (enter text) Please note that an approval or refusal will be emailed to this address. SECTION 2 - Details of Gaming Machine or Peripheral Equipment Name of Gaming Machine or Peripheral Equipment (enter text) Type of Gaming Machine or Peripheral Equipment (enter text) Specification Number (enter text) Application Reference Number (enter text) Does this product allow the use of an audio device that is not designed or intended primarily to assist a person with a hearing impairment? Yes (Please attach details) No Does the product proposed to be approved introduce new technology not previously approved in this jurisdiction? (enter text) Yes (Please attach details) No GAMING REGULATION SECTION USE ONLY – LICENSEE NOT TO COMPLETE THIS PART Y N _____________________________ Signature of Delegated Officer Application fee paid Date: ______/______/____ Technical Evaluation received Signature of Delegate Research considered Approval number: NI_______________________ Application approved Date Notified:______/______/___________ AF2015-74
Contents 1 Instructions 1 2 Preliminary Information 2 3 Assessment Criteria 3 3.1 Summary of Revisions 3 Criterion 1 – the “Essential Works List” 4 3.2 Criterion 2 – Nexus 5 3.3 Criterion 3 – Reasonable costs 7 3.4 Criterion 4 – Reasonable timeframe 10 3.5 Criterion 5 – Reasonable apportionment 11 3.6 Criterion 6 – Appropriate community liaison 12 3.7 Criterion 7 – The plan complies with other matters IPART considers relevant 13 4 Quality assurance 14 5 Attachment checklist 15
GROUP A GROUP B GROUP C Application Fee-W/in Asia 400 300 100 Application Fee-Outside Asia 500 400 Associate Member Annual Fee Association/Organization 420 420 420 Institutions 350 350 350 Accredited Member Annual Fee: Undergraduate 750 580 350 Graduate 850 650 420 Post Graduate 900 750 500 Doctoral Level 950 820 580 VET Fee: Undergraduate Additional / Program 750 90 550 70 350 up to 2 programs 40 each program Graduate Additional / Program 800 100 650 80 400 up to 2 programs 60 each program Post Graduate Additional / Program 850 125 700 100 500 up to 2 programs 80 each program Doctoral Level Additional / Program 950 150 800 120 550 up to 2 programs 100 each program * US $ ASIA THEOLOGICAL ASSOCIATION INTERNATIONAL FEES CHARGED 2016 (IN USD) Group A: Within Asia- Hong Kong, Korea , Malaysia, Japan, Macau, Singapore, Taiwan Outside Asia- USA/ Europe, Israel, Australia B: Philippines, Thailand, Indonesia, Jordan, Vietnam Group C: Bangladesh, India, Mongolia, Myanmar, Pakistan, Nepal, Sri Lanka
_______________________________________ Official name of Applicant _______________________________________ Name and signature of authorised signing officer _______________________________________ Title _______________________________________ Date _______________________________________ Telephone No. (including country code and area code) _______________________________________ Official e-mail address of Applicant
Signed _________________________________________ Dated ___________________ Signature of person giving authority
INTERNAL QUALITY ASSURER(S) - IQA IQA Name Qualifications internally quality assured No. of allocated Assessors IQA* qualification held? (Yes/No) IQA qualification target date, if applicable State how occupational competence requirements are being met Total number of IQA’s who hold a nationally recognised IQA qualification: Number of IQA’s who are working towards an IQA qualification: *Not all ABBE qualifications require the IQA to hold a formal IQA qualification (e.g. D34/V1/IQA); however, all internal quality assurance practice should be in line with the latest standards ASSESSOR(S) Assessor Name Qualifications assessed No. of allocated Assessors Assessor Award** qualification held? (Yes/No) Assessor Award** target date, if applicable State how occupational competence requirements are being met number of Assessors who hold a nationally recognised Assessor qualification: Number of IQA’s who are working towards an IQA qualification: **Not all ABBE qualifications require the Assessors to hold a formal Assessor qualification (e.g. D32&D33/A1/AVA); however, all Assessor practice should be in line with latest standards
Section 2 Certificate details Form of certificate (please choose one option only): Electronic copy via email Hard copy via post If requesting hard copies, please advise how many you require [five (5) maximum] Section 3 Medical device details Your certificate of free sale or export certificate will show the ARTG Number and GMDN codes for your products, the sponsor’s name and address, and the primary manufacturer’s name and address. If your product is a Class III included device, your certificate of free sale will also contain the product / trade name as it appears on your ARTG inclusion. ARTG Number GMDN Code Section 4 Schedules If the country of import requires your certificate of free sale or export certificate to include additional information about the products to which the certificate relates, then the additional information must accompany this application in a schedule on your company letterhead. The schedule heading should describe the contents. If the schedule requires more than one page, subsequent pages should have the same heading followed by ‘page 2’, etc. Please indicate if your application is accompanied by a schedule. Section 5 Fees There is an application fee associated with the processing of your application for a certificate of free sale or an export certificate. The current fee is outlined under “Export” on the webpage. Please indicate the current fee for the processing of your application, and ensure you include a completed and signed credit card authorisation form for this amount when you submit your application. $
What is the length of time it takes to complete the program? (e.g. number of hours/days) What is the average cost per person to complete the program? Please include an itemized budget. Please list the names of other states or organizations in which the program is formally approved. (limit to no more than five (5) states or organizations, but list total number, if desired) Include the length of time in partnership and the organization’s point-of-contact. How many certified trainers of the program do you currently have available to deliver training in MS? If you are in MS what districts/organizations have you trained? Also, discuss the process for becoming a certified/recertified trainer (including cost, time needed, and length of certifications) Additional Information: Please discuss any other items you feel are important for reviewers to know about the program and/or company. Capacity in other states? Outcomes? Delivery Method? Please read the following disclaimers and initial acceptance. Initials I certify that all of the information is true and accurate and that I am an authorized representative of this program/company. I certify that, if approved by the Mississippi Department of Education (MDE), trainers of this program will follow the protocol as outlined in Miss. Admin. Code Pt. 3, Ch. 38, R. 38.13. I understand that MDE has the authority to revoke approval, at any time, should it be discovered that this program is not operating in accordance to Miss. Admin. Code Pt. 3, Ch. 38, R. 38.13.
8. Payment options Contact your local Territory Business Centre for the relevant schedule of fees. Cash - Territory Business Centre Cheque - payable to RTM (Receiver to Territory Money) Credit card Visa MasterCard Credit Card number Expiry Name on card I hereby authorise the Territory Business Centre to debit the above credit card for the amount of $ Amount in dollars Signature of cardholder Date Contact phone number 9. Lodgement options Applications to be lodged at a Territory Business Centre with the prescribed fee. Darwin Ground Floor, Development House 76 The Esplanade Darwin GPO Box 9800 Darwin NT 0801 t (08) 8982 1700 f (08) 8982 1725 Toll free 1800 193 111 e Katherine Shop 1, Randazzo Building 18 Katherine Terrace Katherine PO Box 9800 Katherine NT 0851 t (08) 8973 8180 f (08) 8973 8188 e Tennant Creek Shop 2, Barkley House Cnr Davidson and Paterson Street Tennant Creek PO Box 9800 Tennant Creek NT 0861 t (08) 8962 4411 f (08) 8982 1725 e Alice Springs Ground The Green Well Building 50 Bath Street Alice Springs PO Box 9800 Alice Springs NT 0871 t (08) 8951 8524 f (08) 8951 8533 e
The HSE Consultant Appointments Unit will submit requests for change in Contract Type to the Consultant Applications Advisory Committee / Type C Committee as follows: Applications for change of Contract Type A, B or B* will be considered by the Health Service Executive Consultant Applications Advisory Committee together with the Employer’s views on the application. A decision on such application will be made by the HSE following the advice of the Committee. Applications for change of Contract Type to Contract Type B* will be considered subject to the condition that the number of Consultants holding B*, Type C and Category II Contracts will be subject to an upper limit of such posts within the system. In the event that the HSE does not accede to the request as set out at a) and b) above, the Consultant may refer the matter to the Independent Appeals Panel for a recommendation. The Independent Appeals Panel shall be composed of: an Independent Chairperson, a representative of the Consultant (e.g. from the relevant medical organisation), and an Employer representative. Applications for reclassification to a Type C post will be considered by the Health Service Executive Type C Committee. A decision on such application will be made by the HSE following the advice of the Committee. Applications for change of Contract Type to Type C will be considered with reference to the total number of Consultants holding Type B*, Type C and Category II Contracts not exceeding the specified limit. In the event that the Type C Committee does not accede to the request the matter will be referred to Chief Executive Officer of the Health Service Executive for a final decision. No further appeals process exists. All correspondence / queries should be directed to the: email: HSE Consultants Division Room 2.29 Dr Steevens’ Hospital Dublin 8 Tel: 01 6352132 Appendix IV – Procedures for change in category of Contract under the Consultants Contract 1997 Introduction The procedure for the submission to the HSE, processing and approval of requests for the
and proposed conversion date. Has the MAT (Directors and Members) formally approved in principle you joining? Yes/No Minuted decision taken by the Trust on ____________ (If joining an existing Trust) NB If articles are to be changed approval is also needed by the Members Date of approval: _______________ 3 Please give a brief description of the other schools either already in, or proposing to join the Trust. Names of Schools already in the trust Names of Schools proposing to join the trust with proposed dates for joining. Other schools in ‘conversation’, if known. Please include name of school, age range, number on roll, whether sponsored or not, religious designation and any other information you consider relevant. 3b Will the Trust be a sponsor? Yes/No 4 Why do you wish to be an academy? Please answer the following questions within your narrative. Why this particular MAT? How will this trust challenge you in School Improvement? What is their capacity to offer you support and/ or for you to offer support? How will the trust support, develop, enhance and uphold your Church School Character/ distinctiveness?
STUDENT TO COMPLETE – DETAILS OF PREVIOUS STUDENT TO COMPLETE – CREDIT APPLIED FOR AT MONASH TRAINING AND PROFESSIONAL DEVELOPMENT OFFICE USE ONLY UNIT CODE UNIT TITLE YEAR COMPLETE MONASH Training and Professional Development UNIT CODE MONASH Training and Professional Development UNIT TITLE CREDIT GRANTED? (Y/N) SIGNED OFFICE USE ONLY EVIDENCE ATTACHED (PLEASE CIRCLE): YES NO COMMENTS: PROCESSED BY: SIGNATURE: DATE:
Contact email address: Training Date What Wednesday 26th April 6.30-8.00pm Briefing session for all EYLPs Monday 8th May 6.30-8.00pm ‘Getting to Know You’; opportunity for all EY Lead Practitioners to meet EY Locality Advisers Friday 29th September 9.00-3.30pm EY Lead Practitioner training day Friday 26th January 9.00-3.30pm EY Lead Practitioner training day Please email completed application form to: Deadline for applications to be received: Friday 17th March 2017 at 5.00pm
Application for Emergency Assistance Name_______________________________________________ Number____________________ Address ________________________________________________________________________________________ Street City State Zip Code 1. Head of Household Last Name Name MI Date of Birth Age Sex (M/F) Relation HEAD Disability Yes  No  U.S. Citizen Yes  No  Full-time Student Yes  No  Race Hispanic/Latino Yes  No  Social Security Number Alien Registration Number 2. Household Member Last Name First Name MI Date of Birth Age Sex (M/F) Relation Disability Yes  No  U.S. Citizen Yes  No  Full-time Student Yes  No  Race Hispanic/Latino Yes  No  Social Security Number Alien Registration Number 3. Household Member Last Name Name MI Date of Birth Age Sex (M/F) Relation Disability Yes  No  U.S. Citizen Yes  No  Full-time Student Yes  No  Race Hispanic/Latino Yes  No  Social Security Number Alien Registration Number 4. Household Member Last Name First Name MI Date of Birth Age Sex (M/F) Relation Disability Yes  No  U.S. Citizen Yes  No  Full-time Student Yes  No  Race Hispanic/Latino Yes  No  Social Security Number Alien Registration Number 5. Household Member Last Name First Name MI Date of Birth Age Sex (M/F) Relation Disability Yes  No  U.S. Citizen Yes  No  Full-time Student Yes  No  Race Hispanic/Latino Yes  No  Social Security Number Alien Registration Number 6. Household Member Last Name First Name MI Date of Birth Age Sex (M/F) Relation Disability Yes  No  U.S. Citizen Yes  No  Full-time Student Yes  No  Race Hispanic/Latino Yes  No  Social Security Number Registration Number
5. DESIRABLE CRITERIA Please demonstrate evidence of the following desirable criteria, using no more than 500 characters, by way of examples and dates in the box below. 1. Working towards Accounting Technicians Qualification Are you working towards an AAT qualification? Yes No 2. Familiarity with Housing Management Finance Suite eg Arthur/Xero/Omniledger Please provide evidence of a good working knowledge of a Housing Management Finance system including dates and level of experience. (250 words)
3. Knowledge of Third Sector/ Charity Accounting requirements/ guidelines Please provide evidence of your knowledge of Third Sector/ Charity Accounting requirements/ guidelines system including dates and level of experience. (250 words) 4. Creation of Interim Management Accounts Please provide evidence of creating interim management accounts including dates and level of experience. (250 words) 6. PERSONAL ATTRIBUTES
Please continue on a separate sheet if necessary ADDITIONAL INFORMATION Please give your reasons for applying for this post and why you are suitable for the position and explain what skills, experience and personal qualities you bring to the College, how they relate to the post you have applied for and demonstrate your ability to undertake the duties of the post. If you have done this in your covering letter you may leave this blank. Please continue on a separate sheet if necessary. TRAINING COURSES ATTENDED or OTHER VOCATIONAL QUALIFICATIONS, SKILLS OR TRAINING (relevant to the position applied for) Course Title Course Provider Duration Date Completed EDUCATION HISTORY Please include secondary and further education (University/college/apprenticeship, etc.).
Please state any criminal convictions except those ‘spent’ under the Rehabilitation of Offenders Act 1974. If none please state this. In certain circumstances employment is dependent upon obtaining a satisfactory enhanced check from the Disclosure and Barring Service /Scottish Criminal Records Office. EMPLOYMENT REFERENCES Please give details of three work-based referees. One of your referees must be your present or most recent employer and we will contact this reference only in agreement with you. Referee’s name and job title Full address, telephone number and address In what connection does this person know you? May we approach to interview YES NO Referee’s name and job title Full address, telephone number and email address In what connection does this person know you? May we approach prior to interview YES NO Referee’s name and job title Full address, telephone number and email address In what connection does this person know you? May we approach prior to interview YES NO DECLARATION (Please read this carefully before signing this application)
APPLICATION FOR EMPLOYMENT Application for the post of: Ref No: Surname/Family Name: Forename(s): Email address: Phone Number: Current Employment Name and address of current employer and nature of business Position held, Grade, Full or (if part-time, state weekly working hours) From DD/MM/YY To DD/MM/YY Salary including all allowances Brief description of main duties/responsibilities:
Period of Notice: Weeks/Months: Previous Employment Name and address of previous employer and nature of business (most recent first) Position held, Grade, Full or (if part-time, state weekly working hours) From DD/MM/YY To DD/MM/YY Reason for leaving Education and Qualifications General Education, i.e., GCSE/A/AS/NVQ Level (or equivalent) Name of school/college Dates Subject Grade/Level Date From To
Email Address: Relationship: May we contact them if we decide to invite you for interview? Yes No Email Address: Relationship: May we contact them if we decide to invite you for interview? Yes No Declaration I understand that any offer of employment will be subject to the information on this Application Form and the Declaration of Health Form being complete and correct. I authorise YMCA Norfolk to make any appropriate checks which may be necessary. False information, or failure to supply the details required in the Application Form may make any offer of employment invalid or lead to termination of employment. Name: Sign: Date: Under the Data Protection Act 1998 all records from the recruitment process will be held within in the HR department for a period of one year after which all records will be destroyed. Please send your completed Application Form, Application Survey Form and your CV to or by post to Stephanie Coker, HR/Payroll Administrator, 35-37 Exchange Street, Norwich, Norfolk, NR2 1DP.
PRE-EMPLOYMENT INQUIRY RELEASE In connection with my employment application with Wenzel Associates, Inc., I understand that investigative background inquiries may be made on myself; including, but not limited to, education, consumer credit, criminal, driving, and previous employment, as well as claims involving me in the files of insurance companies when applicable. These reports will include, among other things, information as to my character, work habits, performance and experience along with reasons for termination of past employment. I authorize, without reservation, any party or agency contacted by Wenzel Associates, Inc. to furnish the above information. Print Full Name: Date of Birth: Driver’s License #: Applicant’s Signature: Date:
SCHOOLS School or College From To Degree Date High School Mo: Yr: Mo: Yr: Mo: Yr: College, Trade or Business School 1 Mo: Yr: Mo: Yr: Mo: Yr: 2 Mo: Yr: Mo: Yr: Mo: Yr: 3 Mo: 6Yr: Mo: Yr: Mo: Yr: Veteran of the U.S. Military Service? Yes No If yes, Branch & Rank: Type of Duty: Please list any specialized training: Activities - List school, volunteer or business activities and office held (you may exclude those which indicate race, color, religion, sex, disability, age or national origin): Please list any languages with which you are familiar and check all the boxes which best describes your skill level. Language: Read Write Speak Language: Read Write Speak REFERENCES In the last column, please check whether person listed is a business or personal reference. By placing references here you are giving permission to call those listed for a reference check. Name City & Phone Occupation Years Known Type of Reference 1 Business Personal 2 Business Personal 3 Business Personal Please list any relatives or acquaintances working for this agency: (Name and position) EMPLOYMENT EXPERIENCE Give past employment record as completely as possible starting with your most recent employer. For any unemployed or self-employed periods, show dates and locations. A detailed resume may be submitted in addition to the information contained on this page. Former employers may be contacted. Employer: Dates Employed Phone:
Address: Mo: Yr: Mo: Yr: Work Performed: Job Title: Hourly Rate/Salary Supervisor: Starting $ Final $ Reason for Leaving: Employer: Dates Employed Phone: Address: Mo: Yr: Mo: Yr: Work Performed: Job Title: Hourly Rate/Salary Supervisor: Starting $ Final $ Reason for Leaving: Employer: Dates Employed Phone: Address: Mo: Yr: Mo: Yr: Work Performed: Job Title: Hourly Rate/Salary Supervisor: Starting $ Final $ Reason for Leaving: Employer: Dates Employed Phone: Address: Mo: Yr: Mo: Yr: Work Performed: Job Title: Hourly Rate/Salary Supervisor: Starting $ Final $ Reason for Leaving: ~ Attach additional page(s) if necessary ~ Please Read Carefully and Sign Below I hereby certify that the facts set forth in this application for employment are true, correct and complete to the best of my knowledge. I understand that if I am employed, falsified statements or omission of facts on this application shall be considered sufficient cause for dismissal. I understand that my employment is contingent
2. GENDER Male Female 3. ETHNIC BACKGROUND Please tick which ethnic group you feel you belong to White White British White Irish Gypsy or Irish Traveler Any other White Background Mixed / multiple ethnic groups White and Black Caribbean White and Black African White and Asian Any other Mixed / multiple ethnic background Asian / Asian British Indian Pakistani Bangladeshi Chinese Any other Asian Background Black / African / Caribbean / Black British African Caribbean Any other Black / African / Caribbean background Other Ethnic Group Arab Any other ethnic group 4. DISABILITY
Employer Job Held and Brief Details Reason for Leaving From To Education Provide details of your education history, starting with your most recent / current experience and working back. Please account for any gaps. Continue on a separate sheet if necessary. Name of school, college or university Dates attended from – to Subject Level Result
(Managers) Application for Employment Private and Confidential Return this form to: Reference Number: recruitment@jamores.co.uk Position Applied for: Personal Details Name Title: Forename(s): Surname: D.O.B. Nationality: Gender: Religion: Disability: Contact Information Address: Post Code: Email: Tel No. (Home): Tel No. (Mobile) N.I Number: Current Driving Licence Yes: No: Groups: Expiry Date: Details of Endorsement(s): Are there any restrictions on you taking up Employment in the UK? Yes: No: If Yes, Please Provide Details:
V1 - In sympathy with the Christian Identity of the YMCA Essential P1 - Able to present self and work effectively Essential P2 - High levels of honesty, integrity and discretion Essential C1 - Able and willing to work unsocial hours Desirable C2 - Hold a full driving licence and have own transport Desirable H1 - Able to meet the requirements of the post with or without reasonable adjustment Essential O1 - An understanding of equality and diversity Essential Anything further you would like to add to your application: Hobbies and Interests Please give details of your hobbies and interests:
Application for Employment Equal Opportunity Employer Posted Position Job Opening Title: Hours of Availability Full-Time Part-Time Other Personal Information Full Name: Telephone: Home Address: Cell Resident County: Email: Name of any relative employed with YVEDDI: Position: Any relative on Board of Directors or a Policy Council: Yes No Kinship: Previous employment with YVEDDI: Yes No Position Dates Position Referred by: Travel Travel in safe personal vehicle is required for most positions. N.C. Drivers License # Residence in District or County may be required. Can you re-locate? Yes No Education and Training School & Location Major Course of Study Completed Graduate? Degree Type High School Technical College Graduate Military Describe special skills (machines, repairs, counseling, etc)
I have no religious beliefs I prefer not to say 10. Sexual Orientation What is your sexual orientation? Bi Sexual Heterosexual / Straight Gayman Other (please state) _________________ Gaywoman/ Lesbian I prefer not to say 11. Ethnic Origin Which one of the following groups do you feel most adequately describes your ethnic origin? White British Asian or Asian British – Bangladeshi White Irish Other Asian Background ______________ Other White Background ______________ Black or Black British – Caribbean Mixed – White and Black Black or Black British – African – White and Black African Other Black Background ______________ Mixed – White and Asian Chinese – Mixed Background ____________ Other Ethnic Background _____________ Asian or Asian British – Indian Not known or Asian British – Pakistani I prefer not to say 12. Canvassing Are you related to an employee(s) or trustee(s) of Transform Residential Limited or Ruskin Mill Educational Trust? Yes No If yes, please give details: Name__________________________ Position __________________________________ Relationship to you ______________________ I confirm that the above information is correct to the best of my knowledge. I consent to Transform Residential Limited processing, by means of a computer database or otherwise, any information I provide for the purpose of employment by Transform Residential Limited, in accordance with the Data Protection Act 1998. Signature ______________________ Date _____________
For 2015/16 the Erasmus+ travel grant will be calculated by distance, using the European Commission’s distance calculation tool () – most EU travel from Newcastle will fall into the 500-1,999km band, which will allow €275 per participant. Overnight hotel and subsistence rates will be paid at the British Council’s rates – for full details please see the form which is provided with this application. Subsistence will normally be calculated for the number of training days plus one travel day. 2Proposed training plan – this should include details of the schedule that is being offered by the host Institution, the departments with which you will be working, level of people you will be working with (i.e. administrative, managerial etc.) 3Additional duties to be carried out – this should include details of any student visits, visits to potential new partners, meetings with existing partners to extend the range of mobilities and departments, development of combined study/work placements etc. Once completed, please arrange for the form to be signed off by the relevant Associate Dean (International) and returned electronically to Teaching and training mobility grants 2015-16 Funding information Receiving country Hotel & subsistence amount per day in EUR Denmark, Ireland, Netherlands, Sweden, United Kingdom €128 Belgium, Bulgaria, Czech Republic, Greece, France, Italy, Cyprus, Luxembourg, Hungary, Austria, Poland, Romania, Finland, Iceland, Liechtenstein, Norway, Turkey €112 Germany, Spain, Latvia, Malta, Portugal, Slovakia, former Yugoslav Republic of Macedonia €96
Estonia, Croatia, Lithuania, Slovenia €80 Travel distances Amount Between 100and €180 per participant Between 500and 1999KM: €275 per participant Between 2000and 2999KM: €360 per participant Between 3000and 3999KM: €530 per participant Between 4000and 7999KM: €820 per participant 8000 KM or more: €1100 per participant Please remember that these are the maximum grants available and anything over these amounts must be covered by Faculty funding, so you must ensure you have ADI approval for any additional costs before apply.
Income Support or ESA (Income Related) Job Seekers Allowance (Income Based – not Contribution Based) Child Tax Credit, but are not entitled to Working Tax Credit and your annual income (as assessed by the Inland Revenue) does not exceed £16,190.00 Support Part VI of the Immigration & Asylum Act 1999 The ‘Guaranteed Element of Pension Credit IN ADDITION ONE OR MORE OF THE FOLLOWING CONDITIONS MUST APPLY AND EVIDENCE MUST BE PROVIDED. Please indicate are applicable:- There has been a fire, theft or flood Homeless families – e.g. parent leaving home due to domestic violence Medical condition – e.g. obesity, extreme growth, child with enuresis or soiling problem Bereavement – loss of parent Reconstituted families – e.g. where a child returns to live with one parent, having lived with the other, and financial difficulties arise (child may arrive with no clothing) Conditions of extreme poverty – e.g. situations where families are at risk of being made homeless, high debts etc Move of school due to supported transfer following PRRP process (Permanently Excluded pupil) HOW TO APPLY Read and sign the certificate on the front of this form. Complete the boxes overleaf with your details and your children’s details. If you need help to complete this part of the form, telephone the Children and Young People Information Service on 01454 868008. Attach proof that you are entitled to the Essential Clothing Grant. We accept: a letter from Jobcentre Plus showing that you receive Income Support or Job Seeker’s Allowance (Income Based) and dated within the last three months a copy of your TC602 renewal notice for 2017 – 2018 (valid if you have an income under £16,190.00 and DO NOT receive Working Tax Credit). a copy of your ‘Pension Credit M1000 Award Notice’ showing that you are in receipt of the ‘Guaranteed element of Pension Credit. a copy of your letter (listing all children) from the National Asylum Support Service (NASS) confirming that you receive support under Part VI of the Immigration and Asylum Act 1999. A Bank Statement. Not more than three months old, showing your name, address and which benefit you are receiving. Evidence for the required additional conditions. Return this form to: CHILDREN AND YOUNG PEOPLE INFORMATION SERVICE, SOUTH GLOUCESTERSHIRE COUNCIL, PO , Civic Centre, High Street, Kingswood, , BS15 0DQ Telephone: 01454 868008, email:
4. Information about your company’s debtors Please provide details of a maximum of five debtors on whom you wish Credit Guarantee to provide indications. Terms of payment R R R R R Amount currently outstanding R R R R R Overdues R R R R R Orders on hand R R R R R Credit limit required R R R R R Banking details Full physical address Registered name of debtor & trade style
APPLICATION FOR COUNCIL EXEMPTION Building Regulation 1804 – To exempt a Class 10 building on farm land from any or all of the Building Regulations. An application will only be considered for Class 10 farm buildings less than 500 m2 in floor area. To: Building Surveyor Property Details (details from property title) No. Street City/Area Lot LP/PS Volume Folio CA Section Parish County Municipal District: Horsham Rural City Council Allotment area m2 Owner of Land Owner Postal Address Contact Person Tel No. Fax No. Email Address Proposed Use of the Building (Clearly indicate entire use, eg storage for plants or animals, storage for farm machinery, commercial farm activities, selling product for profit) Signature (Agent/Owner) Signature Date Information Required for Application to be Considered Scaled site plans, floor plan and elevations Copy of Title, including Title Plan Any relevant supportive information Notes Building Regulation 1804 provides Council with the discretion to exempt a Class 10 building (on a case by case basis) to be constructed on farm land and used for farming purposes from all or any of the requirements of the Building Regulations – an exemption will only be considered for a Farm Building up to a maximum floor area of 500 m2 If the relevant Council grants an exemption from all of the Regulations, a Building Permit and Certificate of Final Inspection under the Building Act 1993 are not required for that building. If an exemption is granted, a Planning Permit may still be required for the use, or development of the building. You will be advised if a Planning Permit is required. It is an offence under Section 246 of the Act for an applicant applying for an exemption to provide false or misleading information to Council about the proposed use of a building; the use of the building changes after it has been constructed, Regulation 1011 applies, which requires the building to comply with the requirements for the new use. Examples of what this would mean in practice ie that if it was proposed to use the exempted shed for a Class 7 or 8 use, before any change to that use, a building permit would be required and work would need to be carried out to bring the building into compliance with all requirements for use as a class 7 or 8 building. This may include the installation of fire safety measures such as hose reels, fire extinguishers, fire hydrants, emergency lighting, exit signs and static water storage tanks available for firefighting.
Attached a recent copy of title, including the relevant plan of subdivision, and a copy of any restrictive covenant or Section 173 Agreement which relates to the land? Attached an extra two copies of the plan of the property indicating trees to be removed / pruned (refer below for example)? Attached all necessary supporting information and documents. If insufficient, you will be asked for more information. This will delay our response to your request. Have you signed the declaration? Privacy statement The personal information requested on this form is being collected by Council for the purpose of evaluating an application as set out in the Planning and Environment Act 1987. If you do not provide your name and address, Council will not be able to consider your application. This information will be used solely by Council for that primary or directly related purpose. The applicant may apply to Council for access to and/or amendment of the information. Plan of the property indicating trees to be removed / pruned Sketch the layout of the site (see below for an example of what is required), indicating: The location of (numbered) tree(s) to be removed or pruned. Distance of subject trees from a fixed object (eg. house or fence). Accurate location of dwelling, outbuildings and fences in relation to property boundaries. The location and name of the street frontage(s). The approximate location of north. Access points, and if access is readily available. Tree removal / pruning site plan
Granard Rd Ballyjamesduff Cavan Cork (Midleton, Kanturk,Mallow Bandon) Paudie Collins FRS Network Unit 17 Knockgriffin Ind Park Midleton Cork pcollins@frsnetwork.ie 021 4613501 Donegal Austin Duignan Donegal FRS Oakfield Demense Raphoe Donegal aduignan@donegalfrs.com 074 9145386 Galway Mike Clarke FRS Network The Mart Athenry Galway 091 844551 Kerry John Lyons Kerry FRS Moanmore Ind Est Tralee Rd Castleisland Kerry jlyons@frsnetwork.ie 066 7141099 Kilkenny / Carlow Philip Kenny KCD FRS Cillin Hill Dublin Rd Kilkenny info@kcdfrs.ie 0567761671 Limerick & Clare Liam O’Rourke FRS Network Lottera Bruree Limerick lorourke@frsnetwork.ie 063 90666 Roscommon / Nth West Richard O Dowd FRS Network Greatmeadows Boyle Roscommon rodowd@frsnetwork.ie 071 9662781 Tipperary Nth, Laois, Offaly Kate Fogarty FRS Network Parkmore Roscrea Tipperary kfogarty@frsnetwork.ie 0505 21166 Tipperary South Martin Bourke FRS Cahir Carrigeen Ind Est Cahir Co Tipperary mbourke@frscahir.ie 052 7441598 Waterford Ned Dunphy Waterford FRS Ahanaglogh Kilmacthomas Waterford ndunphy@waterfordfrs.ie 051 294277 Wicklow Kathleen Wynne Wicklow FRS Rosnastraw Tinahely Wicklow kwynne@frsnetwork.ie 0402 38427
Title of Project: Short Description of the Project: Duration of Project: Name of Applicant /Organisation: Project-Partners within the 11 Alps-Adriatic-Alliance Members: (NOTICE: According to Point 1 of the implementation guidelines (see page 12) joint projects must involve at least three members from three countries as an absolute minimum! The number of Alps-Adriatic-Alliance-members involved in the project is an important selection criterion for every application!) Bundesland Burgenland (Austria) Istarska županija (Croatia) Karlovačka županija (Croatia) Bundesland Kärnten (Austria) Koprivničko-križevačka županija (Croatia) Krapinsko-zagorska županija (Croatia) Međimurska županija (Croatia) Republika Slovenija Bundesland Steiermark (Austria) Varaždinska županija (Croatia) Vas megye (Hungary) 1. Project Activities Title of Project:
Calculation of costs: Honorarium for Guest Speaker: _______________________ € Travel Costs for Guest Speaker: _______________________ € Costs of Materials: _______________________ € Other (please name): …………………………………………. _______________________ € Expected Overall Costs ∑ _______________________ € ___________________________ ________________________________ (Date) (Applicant’s Signature) To be filled out by GRADE The application is approved as stated: __________________________ __________________________________ (Date) (Signature)
Question 1.21 This question asks you to explain how your current services could provide future expansion and flexibility, to accommodate the increasing demand and variation of Short Breaks, Clubs and Activities. This cover the expansion of your service into new geographic districts of Essex, or how the service might be changed in order to accommodate more C & YP. This may be an opportunity to look at C & YP with complex needs, and how we might bring affordability to services in this area. There is a maximum word count of one thousand words in this section. Please answer this question as fully as possible as it will be scored against an assessment criteria. Question 1.22 This question gives you the opportunity to explain why your organisation should be an approved supplier of Short Breaks, Clubs and Activities services. You will need to think about what are the key differentiators within your organisation that leads Action for Children to choose you to deliver services. This question allows you to bring together everything you have thought about in earlier questions to drive home your key messages. There is a maximum word count of one thousand words in this section. Please answer this question as as possible as it will be scored against an assessment criteria. Section A - Part 2 – Service Provision Please refer to the Microsoft word document “Application for Funding, Section A and Part 2” Question 2.1 Here we ask you to choose the category that best describes the C & YP that attend your service. We have inserted a table that will allow you, in percentage terms, to show how much your services are catering for the needs of the C & YP There is also an opportunity to provide any further pertinent information that will help convey the service you provide. Question 2.2 This question asks you to outline the and type of activities that C & YP with a SEND can expect to engage in at your setting or settings. This is an opportunity to show the range and diversity of activities that you run for the benefit of the C & YP. is a maximum word count of one thousand words in this section.
Application for funding: Guidance (please delete this section prior to submitting your application) Section Minimum information requirements Purpose of this document The purpose of this document is to enable an initial assessment of a proposed project, in of strategic alignment and context. The committee may seek further details from the applicant prior to making a recommendation to the Minister. If the proposal is approved the information in this document will be used to provide information about your project to a variety of audiences, including Fund Committees, Ministers, Cabinet, or for Annual Reports, Departmental website, and Industry forums. Length and format Please do not exceed 6 pages in total. Font: Calibri 11 Delete this guidance section to provide additional space. Please submit as a Word document to: Project name Please provide a short title for this project (5 or 6 words maximum) Project budget Please indicate estimated total budget from compensation funds and other sources. Indicate cash or in-kind for other sources. Project synopsis A brief summary of the project for use in publications (200 words maximum). For example, a statement about the problem this project will address, an indication of the significance of the problem, how the project will address the problem, the target group. This is your business justification. What’s in scope? What’s out of scope? Project success What does success look like for this project in of achieving its intended outcome/s? Impact and What will be the impact of this work? How will you demonstrate it? What qualitative and/or quantitative data do you plan to collect as part of this project? Alignment to Strategic Intent Please refer to the current Statement of Strategic Intent (see website) and briefly explain the alignment of this proposed project. Underlying What are the underlying assumptions behind this project? (i.e. what are the conditions believed to be necessary for the success of this project) and Indicate any collaboration or co-investment to implement this project Alignment with strategic initiatives Identify any strategic initiatives with which this project aligns on
Grant Streams Available Categories Funding Amounts ($) Creative Hobart - Cultural Organisations - Medium Cultural - Small Cultural - Quick Response Over $10,000 $7,000 to $15,000 $1,000 to $5000 Up to $1,000 Community - Small Community - Quick Response $500 to $5,000 Up to $500 - Event Partnerships - Event - Quick Response Over $20,000 Under $20,000 Up to $1,000 (in-kind only) Christmas - Community Christmas Activation Quick Response - Community Christmas Carols Up to $750 $1,000 - $15,000 Marketing - Shopfront Improvement - Local Trader Marketing - Civic Banner Quick Response Up to $5000 (matched funding) Up to $8,000 Up to $1,000 (in-kind only) Support - Venue Support Quick Response Up to $1,000 (in-kind only) City Partnership - Small - Large $10,000 $30,000 3. The grant streams for Event Grants, Medium Cultural Grants, Small Cultural Grants, Small Community Grants and Shopfront Improvement Grants will be available to the public twice yearly opening in August and February each year. The grant allocation pools will be distributed between both rounds. The Local Trader Marketing Grant will be available to the public once a year for a two month period from February to March.
Name of Employer: Address: Postcode Position Held: worked: description of duties: Reason for leaving: Name of Employer: Address: Postcode Position Held: Dates worked: Brief description of duties: Reason for leaving: Continue on a separate sheet if necessary
288 – Refusal to issue replacement registration document Registration holder The person with management or control of the item of plant Hazardous chemicals and lead 384 – Refusal to grant authorisation to use, handle or store a prohibited or restricted carcinogen Applicant 386 – Cancellation of authorisation to use, handle or a prohibited or restricted carcinogen Authorisation holder 393 – Deciding a process to be a lead process A person conducting a business or undertaking that carries out the lead process A worker interests are affected by the decision 407 – Determining a different frequency for biological monitoring of workers at a workplace, or a class of workers, carrying out lead risk work A person conducting a business or undertaking that carries out the lead process A worker whose interests are affected by the decision Exemptions 684 – Refusal to exempt person (or a of persons) from compliance with any of this Regulation Applicant 686 – Refusal to exempt person from requirement to hold a high-risk work licence Applicant 691 – Imposing condition on an exemption granted on application Part 11.2 Applicant 696 – Refusal to exemption Applicant 697 – Amendment of an exemption granted on application under Part 11.2 Applicant 697 – Cancellation of an exemption granted on application under Part 11.2 Applicant A decision of the regulator the WHS (Mines and Petroleum Sites) Regulation
Commissioner of Oaths Name and address of the Commissioner of Oaths *delete that which is not applicable. 10. Lodgement options Applications to be lodged at a Territory Business Centre with the prescribed fee. Darwin Darwin Corporate Park Ground Floor, Building 3 631 Stuart Highway Berrimah NT 0828 GPO Box 9800 Darwin NT 0801 t (08) 8982 1700 f (08) 8982 1725 Toll free 1800 193 111 e territory.businesscentre@nt.gov.au Katherine Shop 1, Randazzo Building 18 Katherine Terrace Katherine PO Box 9800 Katherine NT 0851 t (08) 8973 8180 f (08) 8973 8188 e Tennant Creek Shop 2, Barkley House Cnr Davidson and Paterson Street Tennant Creek PO Box 9800 Tennant Creek NT 0861 t (08) 8962 4411 f (08) 8982 1725 e Springs Ground Floor, The Green Well Building 50 Bath Street Alice Springs PO Box 9800 Alice Springs NT 0871 t (08) 8951 8524 f (08) 8951 8533 e
3.8 Arrangements for disposal of excreta, bedding and other waste material 3.9 Isolation facilities for the control of infectious diseases 3.10 Fire precautions/equipment and arrangements in the case of fire 3.11 Do you keep and maintain a register of animals? Yes/No 3.12 How do you propose to minimise disturbance from noise? 4 Veterinary surgeon 4.1 Name of usual veterinary surgeon 4.2 Company name 4.3 Address 4.4 Telephone number 4.5 address 5a Emergency key holder 5.1 Do you have an emergency key holder? Yes/No If no, go to 6.1 5.2 Name 5.3 Position/job title 5.4 Address 5.5 Daytime telephone number 5.6 Evening/other telephone number 5.7 Email address 5.8 Add another person? Yes/No If no, go to 6.1 5b Emergency key holder 2 5.9 Do you have an emergency key holder? Yes/No If no, go to 6.1 5.10 Name 5.11 Position/job title 5.12 Address 5.13 Daytime telephone number 5.14 Evening/other telephone number 5.15 Email address 6 Public liability insurance 6.1 Do you have public liability insurance? Yes/No If no, go to 6.6 6.2 Please provide details of the policy 6.2 Insurance company 6.3 Policy number 6.4 Period of cover 6.5 Amount of cover (£)