*Project name

*Name of institution
(if your project involves more than one institution, please indicate this)

*What is the main language(s) involved in the project?

What other languages, if any, are involved?

*Please give a brief outline of the project (maximum 25 words)

*What are the aims of the project?
Why did you do it?  (maximum 100 words)

*Describe the project (maximum 200 words)

*Does the project involve innovative collaboration?(maximum 50 words)

*When was the project started?

*How have you measured your success?

*What evidence do you have of the impact of your project? (maximum 200 words)

*Do you have plans to extend the project? (maximum 50 words)

*How could your project be used as a model for others? (maximum 50 words)

*Have you shared the outcomes of your project more widely? (maximum 50 words)

*Does your project use advanced ICT?

*Is your institution an Initial Teacher Education partnership school?

Yes   No

*How is your project funded?

*How did you hear about the Award? Please specify (e.g. CILT, publicity, LEA etc)

*Give details of the group(s) and number of learners involved, including their age range (maximum 50 words)

*Please give further details of your school, college or institution and its constituency (maximum 50 words)

*Name of project coordinator

Address of lead institution

(this is the address to which all correspondence will be sent)

*Address line 1

Address line 2

*City

*County

*Postcode

*Telephone number

Fax number

*Email

*Name of Head of institution

*Signature
Please write your name to confirm the information you have provided.