Blank Application_form (for organizations).docx

U.S. Embassy Grants Program

APPLICATION FORMAT

Read carefully the instructions supplied with this document

1. GENERAL INFORMATION:

1.1. Applicant Organization

a. Organization (English):

b. Organization (Original):

c. Address: d. City/Town: e. District:

f. Website: g. DUNS #:

1.2. Organization leader/signee of the grant agreement

a. Last Name: b. First Name:

c. Tel: d. Mob: e. Fax: f. E-mail:

2. BACKGROUND OF ORGANIZATION:

2.1. Description

2.2. Past Grants received from the U.S. Government Agencies

2.3. Past Grants (Other)

Last Updated: 05/07/2010 Page 1 of 3

3. PROJECT DESCRIPTION:

3.1. Project information

a. Project Name:

b. Duration (months): c. Start date (mm/dd/yyyy): d. End date (mm/dd/yyyy):

3.2. Executive summary:

3.3. Project Justification:

3.4. Project Goal and Objectives

3.5. Project Activities

3.6. Monitoring and evaluation

3.7. Key Personnel

3.8. Project Partners

3.9. Strengths and Innovation

3.10. Sustainability

4. BUDGET:

4.1. Budget Summary

Total Requested:

$0.00

Project Total

$0.00

Note: You may be asked to submit a detailed budget in a spreadsheet format

4.2 Budget narrative

4.3 Miscellaneous

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