FOR NLT STAFF USE
Select which hub/team this form is for
Please select...
Birmingham Hub
Black Country Hub
Blackpool Hub
Bradford Hub
Communities Team
Connecting Stories Team
Criminal Justice Team
Doncaster Hub
Early Years Team
Fundraising Team
Hastings Hub
Home Learning Environment Team
Love Our Libraries Team
Manchester Hub
Middlesbrough Hub
North Yorkshire Coast Hub
Nottingham Hub
Peterborough Hub
Read NE Team
Sport and Literacy Team
Stoke Hub
Suffolk Hub - Haverhill
Suffolk Hub - Lowestoft
Suffolk Hub - Stowmarket
Swindon Hub
Words for Work Team
Young Readers Team
Young Writers Team
Which KPI metrics does this form relate to? Please tick as many as suitable
Reach
Engaged
Competition Entry
Is this just an expression of interest form or do you want to collect number of attendees?
Expression of interest
Number of attendees
Please select whether this activity relates to Connecting Stories and/or Literacy Champions (leave this as blank if neither apply)
Connecting Stories
Literacy Champions
School Details
Please complete this with the details of the person who will be
delivering the Words that Count programme.
All programme information will be sent to the details provided below.
First Name
Last Name
Are you completing this on behalf of a school or organisation?
School
Organisation
Job Title (including subject if teacher)
Please enter your school or Club Community Organisation email address (not your personal email)
Address
School lookup
P
lease look up your school here, using the
name
or
postcode
.
If your school is not listed,
please leave this field empty
, and manually enter in the
School or Organisation Name
box below - ensure that your address is entered correctly otherwise your resources may be lost).
School or Organisation Name
Street Address Line 1
Street Address Line 2
City
Postcode
County
Delivery information
How many young people do you plan to run the programme with? We recommend a maximum group size of 10. There is a total maximum of 30.
When do you plan to deliver this 6 session programme?
Please enter a rough estimate of a date you may commence delivery. This is not a commitment but will inform us of when we can host a training session for you.
We have some
very limited
funding to support some settings with their delivery where necessary. Will this be some thing you
need
to run the programme?
Yes
No
Per participant, how much financial support would you need to deliver the programme?
For example, £1 for 10 participants would be a total of £10.
Is this address a household or organisation?
Household
Organisation