Grant Application form.docx

U.S. EMBASSY GRANTS PROGRAM

APPLICATION FORMAT

Last Updated: 01/16/2023 Page 1 of 3

1. GENERAL INFORMATION:

1.1. Applicant Organization

a. Organization (English):

b. Organization (Original):

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

f. Website: g. UEI#:

1.2. Organization leader/signee of the grant agreement

a. Last Name: b. First Name:

C. Tel: d. Mobile: 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)

3. PROJECT DESCRIPTION:

3.1. Project Information

Project Name:

Duration (months): Start date (mm/dd/yyyy): End date (mm/dd/yyyy):

3.2. Executive Summary

3.3. Project Justification

3.4. Project Goals 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

Personnel

Fringe Benefits

Travel

Equipment

Supplies

Contractual

Other Direct Costs

Indirect Costs

Total Requested

Contributions

Project Total

Note: Please submit a detailed budget in a spreadsheet format

4.2 Budget Narrative

4.3 Miscellaneous

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