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* 1. First Name

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* 2. Surname

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* 3. Email address

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* 4. Phone Number

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* 5. Affiliation

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* 6. Please provide details of the Lloyd’s Register Foundation or Lloyd’s Register Educational Trust Grant you were awarded (e.g grant number, institution, grant title, start/end date, grant holder's name etc)

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* 7. Please provide brief details of the funded work upon which your impact is based.

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* 8. Please explain the problem or opportunity the grant addressed (including scale if appropriate).

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* 9. Details of the impacts and how they came about

Describe how your funded work made(s) a difference and to whom (impact). Include specific evidence of what and indication of the extent and significance of the impact from the point of view of users and/or beneficiaries. Please be explicit as possible when providing details.

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* 10. What was your role in achieving this impact?

Describe what you did to enable the impact to happen and show how you meet the selection criteria. Again please be explicit as possible when providing details.

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* 11. Please submit sources of evidence corroborating the impact as a single PDF attachment. 

Sources may include but are not limited to emails, articles, letters of support, statistics, testimonials, feedback, data, quotes, links etc

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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