KCC Stop Smoking Support Service Grant Monitoring

About your project:

Name of Organisation*

Your name:*

Email address*

Which districts did your project take place?*

Please select all relevant areas.

Ashford
Canterbury
Dartford
Dover
Folkestone & Hythe
Gravesham
Maidstone
Medway
Sevenoaks
Swale
Thanet
Tonbridge & Malling
Tunbridge Wells

Please can you tell us about your project, how you spent your funding, partners involved and a summary of your targeted community.*

What benefits has the project brought to your organisation?*

Please select all that apply?

Where applicable, please expand on the benefits e.g. which new partnerships are you working with.*

What benefits has the project brought to the local communities involved in the activities?*

Please select all that apply?

Helped create a local community with more confidence to be healthy
Provided the community with more opportunities to be healthy
Helped individuals connect/reconnect with their local community
Helped families come together
Helped people from different backgrounds mix and get on well together
Helped the local community manage their physical health
Helped the local community manage their mental health
The funding has not brought any benefits to the local community
Other benefits on the local community

Where applicable, please expand on the benefits to the community.*

What have been your biggest challenges with this project and how have you overcome them?*

What have been your learnings from the project?*

Were you able to make any referrals to Everybody Health, and if so, how many referrals did you make?*

Is there any feedback from the public about your project or the funding that you would like to share with us?

How have you made sure your project is sustainable so participants can continue to take part?*

How, if at all do you think the funding can be improved to have more impact on either your organisation or local community?*

Is there anything else we can do to support you and your organisation?

What has receiving this funding meant to your club/organisation?*

About your participants:

We want to make sure that everyone is treated fairly and equally, and that no one gets left out. That’s why you will find some equality questions on this evaluation form. We won’t share the information you give us with anyone else. We’ll use it only to help us make decisions, and improve our services.

How many participants took part in your project?*

How many participants were:*

Male?	Female?	Non Binary?	Prefer to self describe?	Prefer not to say?

How many participants were aged:*

0-15	16-24	25-34	35-49	50-59	60-64	65-74	75-84	85+

Did any of the participants have a disability?*

Yes
No

How many participants have a disability?*

Of these participants how many had a:*

Learning Disability	Physical Disability	Sensory Disability	Mental Health Condition	Long Term Health Condition	Other Disability

How many of the participants were:*

of white ethnicity?	from mixed or multiple ethnic groups?	of Asian or Asian British ethnicity?	of black, African, Caribbean or black British ethnicity?	from any other ethnic group?

Any other comments:

Please upload some images of your project taking place.

For example, if possible, please include images of participants taking part in sessions, attending events or some of the marketing produced, which this grant helped to fund.

Drop files here or

Max. file size: 50 MB.

For more information around how we store your personal data, and how we use it please see our privacy notice.

Active Kent & Medway privacy notice

Declaration:*

I confirm that, to the best of my knowledge, the information in this form is true and correct and that I have the authority to submit the form on behalf of the organisation named in this form. I understand that the information and photographs submitted through this form may be used by Kent County Council and Active Kent & Medway, and associated sponsor organisations, in marketing and promotion related to the KCC Stop Smoking Support Service Grant, and confirm that I have collected the necessary consents from anyone featured in photographs for their likeness to be used in this way. To find out more information about how we store and manage your data please read our Active Kent & Medway Privacy Policy.

How would you rate your overall satisfaction with the funding process?*

Thank you for taking the time to complete this Form.

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KCC Stop Smoking Support Service Grant Monitoring

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