Medical Grant Application

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Medical Grant Application

Please complete the application form below, providing as much information as possible.

Note: Click 'Save Application' at any stage to save your application and receive a link via email to continue later.
Application ID
Eligibility Check
I have read and understood the medical grant application requirements.*
I have read and understood the medical grant application requirements.
Medical grants are for sums up to a maximum of £25,000 and ordinarily are for areas such as “pilot study” costs or equipment.

Applications are considered at each of the Trustee meetings which are ordinarily held in March, July and November each year.

If you are applying on behalf of a Registered Charity please ensure that the charity’s most recent Annual Report and Accounts are attached to the Application Form. For successful applicants, a brief report understandable by someone without a scientific background will be required to be sent to the Secretary at the end of the project detailing its outcomes and impacts

Applications may only be submitted via this online form.

I hereby confirm that I consent to The Dowager Countess Eleanor Peel Trust processing any data that may be provided on the application form for the purpose of processing the application and managing any subsequent grant.
Applicant Details
Title*
First Name*
Last Name*
Address Line 1*
Address Line 2*
Town / City*
Postcode*
Email Address*
Phone Number*
Name of the Institution where the research will be undertaken*
Name and title of academic supervisor (if any)
Charity Number (if applicable)
Project Start Date*
Date Format: MM slash DD slash YYYY
Brief description of the charity (if applicable)
Name of Principal Investigator and any co-investigators or key participants*
Grant Details
Project Title*
Amount applied for*
Period of the grant being applied for (months)*
Project Outline*
Project Summary*
Project Protocol*
Project Funding Breakdown*
Project Approval*
Applicant CV*
File Upload
Please upload any files to support your application. These may include bibliography of research proposal, preliminary data, CV of any co-investigators (same format as for Principal Investigator above). No file should be longer than 500 words.
File*
Drop files here or

Accepted file types: pdf, doc, docx.
IMPORTANT: Accepted file types are PDF, DOC, DOCX with a 10mb size limit per file.
Beneficiary Details
Please provide the name and address of the individual to which the cheque is to be made payable and sent to in the event of a successful application. Additionally, please provide the corresponding bank details for payment via bank transfer (BACS).
First Name*
Last Name*
Address Line 1*
Address Line 2*
Town / City*
Postcode*
Bank Details
Bank Name*
Sort Code
Account No.*
Please submit your application using the button at the bottom of the page.
Name
This field is for validation purposes and should be left unchanged.

Save Application

Medical Grant Application

Medical Grant Application

Eligibility Check

Applicant Details

Grant Details

File Upload

Beneficiary Details

Bank Details

Resources

Address