Returning Carers Scheme (Out of Round)

If completing this form by hand, please use CAPITAL LETTERS

PART 1 – To be completed by employee

Section A – Personal and Employment Details
	
Surname	
	
Forename(s)	
	
Title	
	
Email address		
Personal Reference Number	
	
Position held		
School	
	
Faculty / Department 	
	
Contract End Date	
	
Area of Research	
	
Previous applications
Please provide details of successful and unsuccessful applications		

Section B – Career Break / Leave Details

Reason for career break(s) or leave		

Will your child be under the age of one at the time of the event claimed for?	 

                   
                   
                     Yes                          No	

Commencement and end date(s), including date(s) of return to work/usual hours		

Any additional information you wish to provide:

	

Section C – Application for Funding

Please complete the relevant sections as appropriate according to the examples given below. Where possible, please separate costs for yourself from costs for your child and or carer.

Requests for funds should not normally exceed £10,000 in total (although exceptional cases for support up to £20,000 may be considered).  The cost of consumables should not exceed £3,000.	
Conferences
 	Funds Requested (£)
Please note that expenses, including travel, accommodation and subsistence allowances, should be at University rates: http://www.admin.cam.ac.uk/cam-only/offices/finance/procedures/expenses/index.html	
Name, Location and Dates	Conference Fees	Travel	Accommodation	Other	Total	
e.g. Faith and Globalised Society Conference
Yale University
28 February – 3 March 2017	Registration: £100
		Return flights for self: £774.50. Return flights for child and carer: £774.50	3 nights double hotel room: £180
			£1,829	

				

	
					Total:
	
Collaborator Visits	Funds Requested (£)	
Details	Travel	Accommodation	Other	Total	
e.g. Visit to co-author in Berlin, 1-3 April 2017	Return flights: £80			£80	
					
				Total:	

Section C – Application for Funding	
Consumables	Funds Requested (£)	
e.g. Editing software	£300	
		
	Total:	
Research Support
When requesting salaries for research assistance,  please ensure the request is at an appropriate salary and point of the scale (using on-costs) in line with the University’s Salary scales: 
https://www.hr.admin.cam.ac.uk/pay-benefits/salary-scales 
and guidance on starting salaries:
https://www.hr.admin.cam.ac.uk/recruitment/stage-4a-appointment-administration/determine-starting-salary/external-appointments 
(e.g. A new external appointment will normally join on the minimum salary point of the grade, with the exception of Research Associates.)	Funds Requested (£)	
Type of Support	Dates/Duration	Details	Cost	
e.g. Research Assistant	1 February – 30 April 2017	Salary	£6,255.75

			Total:	
Other	Funds Requested (£)	
		
	Total: 	
Total funding applied for:	£	

Section D – Case for Support	

Please briefly outline how the break has affected your career and how the award(s) will support the development of your research profile or other academic activity.

Any additional information you wish to provide:

Section E – Declaration  (To be completed by applicant)

I am applying for an award(s) under the Returning Carers Scheme under the following terms of the guidance:  

Eligibility Criteria
All academic or research staff who:

•	Have returned from a break in their career for caring responsibilities in the last 5 years
•	Are currently on a break in their career for caring responsibilities
•	Are due to go on a break in their career for caring responsibilities
•	Have been working part-time or reduced hours because of caring responsibilities
•	

This can include, but is not restricted to:
•	Adoption leave
•	Career breaks for family reasons
•	Maternity leave
•	Paternity leave
•	Parental leave
•	Leave to work part-time or reduced hours for family reasons under the University's flexible working policy
•	Special leave to care for a dependant

The period of continuous/total/reduced hours family leave should normally be 3 months or more in order to be eligible for support under this scheme. The panel reviewing the applications will consider each case individually, depending on the specific circumstances and needs of the individual.

I am aware that routine costs of research which should be funded through grant funding are not eligible claims under this scheme. Also, requests for personal salary support or for items essential for a member of staff's research (which are funded through the research project) are not eligible.	
Signed (applicant)	

	
Date	

	
Please attach a copy of your CV to this application form and send these to your Head of Department for completion of Part 2.	

PART 2 – To be completed by Head of Department

Section A – Statement of support	

Outline of case to include:
•	Confirmation that the application is in line with the aims of the Scheme 
•	Confirmation that the items requested are of personal benefit to the member of staff
•	Details of how an award will benefit the applicant’s career
•	Confirmation that there is no other source of funding for the items requested (e.g. grant funding) 
•	Confirmation that there will be no adverse effect on colleagues 

	
Signed  (Head of Department)		
Date		
Complete Cost code (for departmental use)		

Please send the complete application together with the applicant’s CV to returningcarers@admin.cam.ac.uk
For Departmental Administrators, please see Guidance Document which can be found at: https://www.hr.admin.cam.ac.uk/files/daguidance.pdf