Pfizer UK Climate Action ProgrammeApplication form

The Pfizer UK Climate Action Programme is initiated and funded by Pfizer and will be delivered by the School for Social Entrepreneurs (SSE), who will have full responsibility for candidate selection and administration of the programme on Pfizer’s behalf.

We know you may not have everything in place yet. Please try to answer all the questions as fully as possible. If you don't know something, please say this or write "N/A" rather than leaving blank.

Feel free to contact us to ask questions at diego.yepez@sse.org.uk

This form should be completed in the name of the lead applicant, who will be the person who will attend the interview and the programme.

Please be aware that responses for each field in this form are limited to 50 characters. For longer answers, kindly upload a Word document. If you encounter any issues, feel free to contact us.

The closing deadline for applications is on Tuesday 10th December 2024 (12 pm).

Support with completing your application form:

• Guidance: Please carefully read the Application Guidance.

• Webinars: To find out more about the programme, help you understand the criteria and how to apply, you will be able to book onto webinars. We will share information of those events via our website page. If you book and can't attend, we can send you a recording.

• Helpdesk: Ask questions and get advice on completing your application at diego.yepez@sse.org.uk

• One-to-one support: If you have difficulty filling in forms because of dyslexia, language or disability, or need one-to-one advice about applying, we have a limited number of one-to-one sessions available. Please contact the helpdesk if you need to access these.

Data protection

The School for Social Entrepreneurs (“SSE”) is committed to protecting your personal information and acting in line with your rights under data protections laws and will treat all data in accordance with our Data Protection Policy.

To process your application, SSE will collect and use personal information provided by you in this form or separately, or which we otherwise lawfully obtain about you. We may use this information to;

• process your application and manage the selection process for this programme

• conduct due diligence on you and your organisation

• contact you about your application for this programme by phone or email

If your application is successful, we may also use your information for:

• managing your participation in the Programme

• sharing and promoting your story and the story of your community business

• other lawful reasons

We may share your information with our funders and partners. They will also only use your information for the reasons above.

Further details, including how we share your information and your rights relating to our use of your information, can be found under our Data Protection Notice, a copy of which is available here: https://www.the-sse.org/your-data

In proceeding with your application you agree to us processing your application in accordance with our data protection policy.

Throughout this form a * indicates a required field.

A: Your details

A1. Name

A2. What is your preferred name, if different from the above?

A3. Your pronouns?

Examples include she/her, he/them, they/them, etc.

A4. What is your role in your organisation?

A5. Email address

A6. Your mobile phone number (or other phone number if no mobile)

A7. Your home address

Street address

Town/City

County

Post Code

State/Province

Country

A8. Your birthdate

A9. We want our programme to be as accessible as possible.

If you feel you require any reasonable adjustments in order to attend the online interview, or participate in the programme, due to disability, caring responsibilities or other reasons, please give brief details below and we will contact you for further information.

A: Eligibility Questions

A10. Please confirm you will be the lead participant and will commit to attending at least 80% of the learning programme

Yes

No

The person who attends the course should be the named lead applicant

A11. Please confirm that you are at least the age of 16 and resident and eligible to work in the UK

Yes

No

If you are under 16 or not eligible to work in the UK, you may not be eligible for our programmes, please contact us if you want to discuss further.

A12. Have you or anyone else in your organisation previously applied to SSE?

Yes

No

If so, please provide details

A13. Do you work for or are you connected (financially or by family) to anyone who is employed by or is a board member of SSE or Pfizer UK?

Yes

No

If so, please provide details

A14. How did you hear about this programme?

If other, where did you hear about us?

C: More about your organisation

Impact

C1. Where you work: Provide one postcode where your project activities are mainly based.

This might be the same as your address or a different postcode where your activities mainly take place.

C2. What is the main impact area of your organisation or project?

If other, please describe your impact

C3. What is the secondary impact area of your organisation or project?

If other, please describe your impact

C4. Who are your main beneficiaries?

If other, please describe your impact

C5. Beneficiaries: Approximately how many people have benefitted from your activities in the last year?

A broad idea is fine, you don't need to count them!

D: Your Finances

D1. What is your organisation's most recent financial year end date?

D2. Income in the last financial year: If you have had any income to date, please provide details of income in your last financial year or the last 12 months?

D3. Expenditure in the last year: What was your organisation's expenditure in your last financial year?

D4. This year: What is your organisation's income likely to be this year?

D5. This year: What is your organisation's expenditure likely to be this year?

D6. What percentage of your current income comes from trading activity? Trading may include sales of goods or services, contracts, rental income

Please round to the nearest whole percent (e.g. 20% not 20.5%).

D7. Private benefit: Say yes if any of the following are true: Do you:
*Pay dividends (payments to shareholders)?
*Pay rent to people who are on your board or have a close connection to the organisation?
*Pay salaries above the market rate?
*Pay interest on loans to members of the organisation or board members?
*Pay companies or business that are linked to board members?

Yes

No

If Yes, please tell us more about this

D8. Do you have lived experience of the issue that your organisation or project addresses?

D9. Please tell us which of The Social Value Model activities your organisation aligns most closely with. (Please tick both if both apply):

Delivering measurable environmental activities which support communities to work towards net zero Educating and raising awareness about climate change through activities that support environmental protection and improvement in their communities.

E: Tell us more about your work and your plans

Here is where you can tell us about yourself, your organisation and why you want to take part in the programme.

Please answer the following 3 questions in a Word document, no longer than 1 page, and upload it below.

Ensure all the questions are covered in your response. We encourage you to be as comfortable and confident as possible throughout the application process.

E1. Your Plans

1. Provide a brief description of your organisation or project. Where is it, what does it do, what activities or services does it provide? 2. How do your activities to promote environmental sustainability, reduce carbon footprints, or enhance biodiversity? 3. Why do you want to take part in this learning programme? How will this learning programme make a difference to you and to your organisation?

F: And finally...

F1. Uploads

Unincorporated organisations only - Provide a copy of your constitution (we can access this information online if you are registered with Companies House, FCA or Charity Commission)

Provide a copy of your most recent statutory accounts

These should be full accounts, including your income/expenditure or profit/loss sheet, (not abbreviated or filleted account). If you don’t have statutory accounts yet, for example,because your organisation is less than 2 years old, please submit a draft set of accounts or management accounts for the last year.

A case study or your social impact report (optional)

F2. Authorisation: I confirm that I am authorised to submit this application.

Yes

If you have any problems uploading files here or wish to provide us with anything at a later date, please email diego.yepez@sse.org.uk using the file naming guidelines outlined above.

Please state your full name and the name of the programme you are applying to in the subject line of the email e.g. 'Jane Smith Pfizer UK Climate Action Programme additional documentation'

Once you're ready to submit your application, click 'Submit' and this will take you to a preview of your application. Please review your application and then click 'submit' again on the bottom of that page.

Once you have submitted you will be taken to the Equalities Monitoring form. Please complete this form.