Application for Project Funding by the Canada Fund

Application for Project Funding by the Canada Fund

Please select one CFLI Priority Area:

1. Protecting human rights and fundamental freedoms, including religious freedom and LGBT rights;

2 Preventing sexual violence and early forced marriage;

3. Supporting democratic transition and expanded democratic participation, particularly by women and minority groups;

4. Entrenching the rule of law and combatting the destabilizing impact of crime and corruption, including through security sector capacity building;

5. Strengthening economic governance, including building free markets and an effective enabling environment for business; and

6. Delivering urgent, targeted responses to disasters or emerging crises, with a focus on small-scale humanitarian support.

I. Project Information:

A) Project title:

(Please provide a descriptive title. For example, Helping Kids Deal with Bullying)

B) Name of NGO/community/group:

C) Location(s) of Proposed Project:

City/village:

Region:

Oblast:

D) Contact person:

Title/function:

Address:

Phone:

Fax:

E-mail:

E) Brief description of the NGO/community/group submitting the project (i.e., date of establishment of the group, mandate, membership, etc.) List the names and responsibilities of the key individuals to be involved in the implementation of the project (project team).

Limit of 3000 characters

II. Project description:

A) Brief description of the project:

Limit of 12000 characters (2 pages)

a) PURPOSE: What do you hope to achieve with the project for the community? (one sentence)

b) RESULTS[1]: What will be the effects of the project activities onto the targeted population and the community? (maximum of four, in bullet form)

c) REACH: Who is your target audience? (one sentence)

d) LENGTH OF PROJECT: Over what period of time will the project be implemented? (maximum of two sentences)

e) RISKS: Identify three major risks that could affect the successful implementation of the project. How will they be tracked and mitigated?

f) ENVIRONMENTAL CONSIDERATIONS: Describe any possible environmental impacts or benefits the project might have.

g) GENDER SENSITIVITY: How will the project ensure that the needs and perspectives of both women/girls and men/boys are considered throughout the project?

B) Project Activities Schedule and Outputs: (Timeframe and key milestones with outputs [2] associated)

Table not to exceed 1 page

Key Milestones (Activities)	Date	Outputs
(add rows as necessary)
Target End Date (should be prior to March 31 2015)

C) Background and Context:

Limit of 3000 characters (1/2 of the page)

Please describe the challenge you are trying to address through this project.

D) Beneficiaries and Participants:

Limit of 7000 characters

a) BENEFICIAIRIES: Who will benefit from the project? (Total number of recipients and number of men, women (over 18), and/or boys and girls (under 18). Please specify age range if the project is specifically targeting a particular group like senior, youth, children, unemployed adults etc..)

b) PARTICIPANTS: Are you also targeting other groups to help ensure that the beneficiaries are reached? For example, your project may focus on children, so the project would involve teachers or parents also.

c) PLANNING INVOLVEMENT: How were the beneficiaries or partners involved in the decision to seek funding and the planning and design of the project? If so, how?

d) GENDER IMPACT: How have you considered the differential impact this project will have on women and men, boys and girls in the community?

e) SUSTAINABILITY: Do you anticipate that the participants will carry on some of the activities after project completion?

E) Summary Project Budget:

Provide the proposed project budget, using a sample budget format below.

	Ukrainian Hryvnia (UAH)	Canadian Dollars (CAD) To convert use 12.0 exchange rate
SECTION 1: Budgeted Project Activity Costs:
Key Activity 1
Key Activity 2
Key Activity 3
Key Activity 4
(up to a total of four key activities)
TOTAL PROJECT COST:
SECTION 2: Project Funding Sources:
Proposed CFLI Contribution
Recipient Contribution
Other Donors (specify)
TOTAL Project Funding (must match TOTAL PROJECT COST in section 1):
SECTION 3: CFLI Funded Activities Describe all project costs to be covered by the CFLI contribution. Consult instructions of the Call for Proposals at (insert link to the Embassy website) outlining eligible and ineligible expenses under CFLI funding. Please breakdown costs with as much detail as possible.
(insert additional lines as necessary)
TOTAL for CFLI funded activities (must match Proposed CFLI Contribution in section 2):

F) Past Experience

Limit of 7000 characters (1 page)

a) Describe any relevant projects already implemented by the NGO/community/group, including the source of funding, the means of execution, and the results. Is this proposal building on past projects?

b) Give information on any previous projects supported by the Government of Canada - when was the project funded, for how much, whether the project was successfully completed.

Prepared by:

Name:_______________________

Signature: ___________________

Position: _____________________

Date:________________________

(More than one signature may be given, if desired.)

[1] Results are effects or desired changes that the project is anticipating. For example, increased understanding of human rights …. OR Increased ability to deal with bullying at school or on the playground OR improved skills in developing a community strategy to deal with garbage more economically that is environmentally friendly. OR increased engagement by the local businesses in community issues

[2] Outputs are the concrete products or activities completed, e.g., brochures developed and distributed, seminars completed, advice provided, strategies developed, community consultations completed.

Дата добавления: 2015-08-27