4 Applicant Organizational Information.DOC
DOC document 51 KB Posted
- Attached to
- Intercultural TechCamp for Climate Change Federal grant opportunity
- Opportunity number
- PD-TLV-FY23-01
- Issued by
- Department of State US Embassy Tel Aviv
About this file
Applicant Organization Information form
View the file
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| File | Type | Posted |
|---|---|---|
| Budget-Worksheet-SE.xls | XLS spreadsheet | |
| 5 Project Narrative Template.docx | DOCX document | |
| 3 SF424B_2025.pdf | ||
| 2 SF424A-2025.pdf | ||
| 1 SF424.2025.pdf | ||
| NOFO Intercultural Techcamp Israel FINAL March 16.pdf |
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Applicant Organizational Information
GENERAL INFORMATION
1. Organization Name:
2. Type of Organization (mark all that apply)
| Non-U.S. Based: |
| |_| |
| Non-Profit: |
| |_| |
| Non- |
Governmental:
| U.S. Based: |
| |_| |
| For-Profit: |
(Commercial)
| |_| |
| Educational |
Institution:
3. Is your organization incorporated, registered, or licensed as a legal entity: |_| Yes |_| No (Please submit a copy of your final registration proof with your application)
| If Yes: |
| Place of Incorporation or Registration (City/Country): |
Incorporation or Registration Date (DD/MM/YYYY):
| If No: |
| List parent company or organization name and address OR explain status below: |
4. President of the Organization:
Full Name:
Title:
Email Address:
Telephone Number:
Address:
5. Program Director (The person who will oversee the day-to-day activities of the grant):
Full Name:
Title:
Email Address:
Telephone Number
Address:
ORGANIZATION STRUCTURE
| 1. Is your organization governed by a Board of Directors? |
| |_| Yes |_| No |
2. How many employees are employed by your organization?
| 3. Is your organization fully registered with the System for Award Management (SAM)? |
| |_| Yes |_| No |
| If No, please explain: |
| 4. Does your organization have a UEI number (Obtained through SAM.gov)? |
| |_| Yes |_| No |
| If yes, please list your UEI # |
| 5. Does your organization have the CAGE/NCAGE Code? (No longer required for organizations not working with Department of Defense) |
| |_| Yes |_| No |
| If yes, please list your Code # |
FINANCIAL BANKING INFORMATION
| 1. Does your organization have a valid bank account? |
| |_| Yes |_| No |
If yes, please provide the banking information below:
Bank name
Bank address
BACKGROUND and PARTNER INFORMATION
1. Has your organization received or is it expected to receive other funding from the Unites States Government?
|_| Yes |_| No
2. Has your organization received or is it expected to receive financial assistance from other donors?
|_| Yes |_| No
If yes, please provide the information requested below on all awards or funding received in the last five years or expected to be received in the future specifically note if funds are U.S. Government (USG) funds.
| Name of Donor |
| Amount (USD) |
| Period |
| Place of Implementation |
| 3. Do you have partner organizations working with you on this project? |
| |_| Yes |_| No |
If yes, please list the name(s) of your partner organizations and how they will assist on this project:
| 4. Has your organization ever been convicted of a felony criminal violation under U.S. or Moroccan law or has it received a U.S. Government award that was canceled or terminated due to Mismanagement or Fraud? |
| |_| Yes |_| No |
If yes, please explain:
5. Please include a brief description of your organization’s history, background, and mission as well as past work & experience in this area. (250 words max)
- 1 - PAS – Applicant Organizational Information
- 2 - PAS – Project Narrative Template
File details come from the government source that posted it. Updated .