Application Form - Ngos
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EWI Application Form for NGOs
Ecumenical Women’s Initiative
APPLICATION FORM FOR NGOs Please carefully read through the document “Guidelines and Criteria for Proposals“ before you begin to fill out the Application Form.
1. Name of organisation: 2. Address: 3. Name of person responsible for the project: 4. Tel/fax, e-mail and/or mobile of person responsible: 5. Title of project: 6. Project summary – briefly describe (in no more than 10 sentences) the problem which you seek to address, the people who will benefit from this project, activities and aims. 7. Why does your organisation exist and what are its aims? 8. Underline one the fields within which your project falls: 1. peace-building and reconciliation 2. ecumenical and inter-religious cooperation 3. gender advancement 9. Location of project: 10. Timeframe: 11. Briefly describe the social, economic and political context in which the project will be implemented. 12. Describe the problem your project seeks to address. How was this problem identified and whom does it affect? 13. Describe the beneficiary group and include number, gender, age, religious and ethnic background as well as the criteria by which they have been selected. 14. What is the project’s long term aim and what will change in your community following the project’s implementation? 15. What are the project’s short term aims and in what way will this benefit the beneficiary group following this project? 16. List the activities, timeframe and person responsible for the planned activities. (Describe each activity in detail and where needed please extend the table). activity
timeframe
person responsible
1
EWI Application Form for NGOs 17. Who is responsible for monitoring this project? Please describe how monitoring will be done? 18. List the indicators which point to the project aims having been achieved. (Indicators must be measurable). 19. Who will be included in the project's implementation and what are their qualifications and experience? 20. What are the project's follow-up plans? 21. Total amount requested from EWI (in EUR): 22. Bank details: a. bank b. bank address c. BIC/SWIFT code d. name of NGO e. account no. NGO / IBAN 23. Are there already any other means secured for this project or any that are pending (financial or otherwise)? 24. If your group its own means for this projects (technical support, space...), please describe them briefly. 25. Do you plan to access local support for the implementation of this project (e.g. volunteers, specialist support, premises, technical materials...) from the local municipality? 26. Please use this space to include any additional information which would allow us to better understand your planned activity: 27. List contact details for at least 3 institutions religious communities or donors who are well acquainted with the work of your group (state name, position and organisation, telephone and e-mail): 1. ........................................................................................... 2. ............................................................................................ 3. ............................................................................................ 28. Please underline how you learned of the EWI Call for Proposals: a. through NGO networks
b. through magazines/journals c. through colleagues/friends
d. through faculties
e. other
NOTE:
The Budget table below must be completed and sent with the Application Form. The Glossary may be used to clarify terms used. Place and date: ………………………
………………………… Signature of person responsible for the project:
2
EWI Application Form for NGOs
EWI BUDGET TABLE Please describe all planned costs and their sources as EWI. If the project will be implemented in Croatia the budget should be in HRK. For all other countries the budget should be in EUR. (Please use the EWI budget table and for all budget items put short description in your project proposal).
PROJECT TITLE
no.
description
A.
DIRECT COSTS
1.
Salaries for full time project personnel
unit
amount
cost per unit
total
amount requested from EWI
other funding sources
Bookkeeper
2.
Honorariums
3.
Project implementation costs
4.
Communication costs
5.
Travel costs
6.
Banking costs
B.
OFFICE COSTS
C.
TOTAL OF ALL PROJECT COSTS:
3
Ecumenical Women’s Initiative
APPLICATION FORM FOR NGOs Please carefully read through the document “Guidelines and Criteria for Proposals“ before you begin to fill out the Application Form.
1. Name of organisation: 2. Address: 3. Name of person responsible for the project: 4. Tel/fax, e-mail and/or mobile of person responsible: 5. Title of project: 6. Project summary – briefly describe (in no more than 10 sentences) the problem which you seek to address, the people who will benefit from this project, activities and aims. 7. Why does your organisation exist and what are its aims? 8. Underline one the fields within which your project falls: 1. peace-building and reconciliation 2. ecumenical and inter-religious cooperation 3. gender advancement 9. Location of project: 10. Timeframe: 11. Briefly describe the social, economic and political context in which the project will be implemented. 12. Describe the problem your project seeks to address. How was this problem identified and whom does it affect? 13. Describe the beneficiary group and include number, gender, age, religious and ethnic background as well as the criteria by which they have been selected. 14. What is the project’s long term aim and what will change in your community following the project’s implementation? 15. What are the project’s short term aims and in what way will this benefit the beneficiary group following this project? 16. List the activities, timeframe and person responsible for the planned activities. (Describe each activity in detail and where needed please extend the table). activity
timeframe
person responsible
1
EWI Application Form for NGOs 17. Who is responsible for monitoring this project? Please describe how monitoring will be done? 18. List the indicators which point to the project aims having been achieved. (Indicators must be measurable). 19. Who will be included in the project's implementation and what are their qualifications and experience? 20. What are the project's follow-up plans? 21. Total amount requested from EWI (in EUR): 22. Bank details: a. bank b. bank address c. BIC/SWIFT code d. name of NGO e. account no. NGO / IBAN 23. Are there already any other means secured for this project or any that are pending (financial or otherwise)? 24. If your group its own means for this projects (technical support, space...), please describe them briefly. 25. Do you plan to access local support for the implementation of this project (e.g. volunteers, specialist support, premises, technical materials...) from the local municipality? 26. Please use this space to include any additional information which would allow us to better understand your planned activity: 27. List contact details for at least 3 institutions religious communities or donors who are well acquainted with the work of your group (state name, position and organisation, telephone and e-mail): 1. ........................................................................................... 2. ............................................................................................ 3. ............................................................................................ 28. Please underline how you learned of the EWI Call for Proposals: a. through NGO networks
b. through magazines/journals c. through colleagues/friends
d. through faculties
e. other
NOTE:
The Budget table below must be completed and sent with the Application Form. The Glossary may be used to clarify terms used. Place and date: ………………………
………………………… Signature of person responsible for the project:
2
EWI Application Form for NGOs
EWI BUDGET TABLE Please describe all planned costs and their sources as EWI. If the project will be implemented in Croatia the budget should be in HRK. For all other countries the budget should be in EUR. (Please use the EWI budget table and for all budget items put short description in your project proposal).
PROJECT TITLE
no.
description
A.
DIRECT COSTS
1.
Salaries for full time project personnel
unit
amount
cost per unit
total
amount requested from EWI
other funding sources
Bookkeeper
2.
Honorariums
3.
Project implementation costs
4.
Communication costs
5.
Travel costs
6.
Banking costs
B.
OFFICE COSTS
C.
TOTAL OF ALL PROJECT COSTS:
3
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