Application Youth camps 2022.doc
DOC document 227 KB Posted
- Opportunity number
- 004-FY2022
- Issued by
-
Department of State US Embassy Sarajevo
About this file
Application form
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Text version
PROJECT PROPOSAL
U.S. Embassy
AEECA INTERETHNIC CAMPS
1. APPLICANT’S CONTACT INFORMATION
a. Implementing organization:
b. Contact Person and Title:
c. Address/ Postal Code and City:
d. Phone number:
e. E-mail:
2. BASIC INFORMATION ABOUT THE PROPOSAL
| A. |
| Project title: |
| B. |
| Amount requested (USD): |
| Cost Share (USD) IF APPLICABLE: |
| Total Cost (USD): |
| C. |
| Duration |
| Entire project: |
| Camp: |
| D. |
| Beneficiaries |
| Number: |
| Age: |
3. ELEVATOR PITCH
(SHORT SUMMARY OF THE PROJECT, NOT TO EXCEED 50 WORDS)
4. DEFINITION OF SITUATION
5. PROJECT OUTCOMES
6. DESCRIPTION OF PROJECT ACTIVITIES AND RECONCILIATION METHODOLOGY
7. ACTIVITY LOCATIONS
8. PROJECT BENEFICIARIES AND SELECTION PROCESS
9. PROJECT SCHEDULE AND TIMELINE
10. PROJECT PARTNERS
11. KEY PERSONNEL
12. ANTICIPATED OUTPUTS OF THE PROJECT
13. MONITORING AND EVALUATION PLAN
14. PROJECT SUSTAINABILITY
15. BACKGROUND OF IMPLEMENTING ORGANIZATION
16. PREVIOUS U.S. GOVERNMENT FUNDING
17. DETAILED BUDGET (itemize any amount larger than $200):
| A |
| B |
| C |
| D |
| E |
| ITEM |
| NO. OF UNITS |
| PRICE PER UNIT |
| U.S. SHARE OF THE COST |
| APPLICANT’S SHARE OF THE COST |
(IF ANY)
TOTAL
(A x B)
(C+D)
| A. |
| Personnel |
SUBTOTAL A
| B. |
| Fringe |
SUBTOTAL B
| C. |
| Travel |
SUBTOTAL C
| D. |
| Supplies |
SUBTOTAL D
| E. |
| Contractual |
SUBTOTAL E
| F. |
| Other Direct Costs |
SUBTOTAL F
GRAND TOTAL (A+B+C+D+E+F)
18. BUDGET NARRATIVE
Molimo pročitajte svaku izjavu ispod i oznacite svaki okvir za potvrdu da je vaš prijedlog u skladu sa sljedećim smjernicama:
Projekat obradjuje jednu od zadatih tema iz javnoga oglasa za dostavu projekata.
Posjedujemo saglasnost učesnika i partnera za realizaciju projekta.
Datum pocetka projekta nije fiksan i moze se prilagoditi dinamici evaluacije projekta od strane donatora (u slucaju da se datum pocetka projekta ne moze mijenjati, ostaviti prazno, a datum navesti u projektnoj aplikaciji).
Organizacija koju predstavljam trenutno nema aktivan grant u kategoriji AEECA programa za koji aplicira.
Troskovi projekta navedeni u budžetu ne ukljucuju PDV.
Svi troskovi projekta su jasno definisani i ne ukljucuju definicije tipa nepredvidjeni troskovi, ostali troskovi i sl.
U budžetu nema troskova koji bi nastali van teritorije BiH.
Svi troskovi veći od 200 dolara su raščlanjeni ukoliko je to moguće (npr. 2 dana X 20KM x 3 osobe).
Aplikacija koja se nalazi u prilogu ne premašuje 6 stranica uključujući i budžet.
Ja vaše ime i prezime , kao osoba odgovorna ispred naziv vaše organizacije., potvrđujem sve gore navedeno.
THIS SPACE FOR INTERNAL U.S. EMBASSY USE ONLY
Page | 6
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