SSH2021-APPLICATION-FORM-Concept-Note.docx

AMBASSADOR'S SPECIAL SELF-HELP PROGRAM

SSH 2021 Application

Guidelines Instructions Application Form (Updated: January 2021)

Introduction

Launched in 1964 in Togo, the Ambassador’s Special Self-Help Program (SSH) is a unique mechanism that enables U.S. embassies around the world to support small-scale community-based initiatives that promote self-reliance, foster development, and promise an immediate and dramatic effect on local communities.

Please note: that this call for applications does not constitute a guarantee that any proposals will be funded. The number and total value of the final awards is dependent on available funds.

Program Eligibility

All SSH proposals must:

For SSH 2021, we will prioritize projects focusing on projects that address gender equality and women’s empowerment. We will accept all applications, but priority will be given to those two focus areas.

APPLICATION PROCESS

1. Application Package: Complete applications must include the following:

a. Completed 2021 SSH application form

b. Completed Budget package (Annex B) to include the detailed line-item budget as well as a Budget Narrative that includes substantive explanations and justifications for each line item in the detailed budget spreadsheet.

c. A copy of the organization’s registration certificate, if available.

d. A letter of approval for proposed project from the local development committee, tribal authority, and/or local town or district council.

e. An original invoice/quotation from any intended suppliers. Three quotes for each item are required.

All application materials must be submitted in English. Do not exceed the space allotted for each question. Please make a copy of your entire application for your own records.

Applications that do not follow this format or are incomplete will not be considered. Applicants should explain how the project fulfills the selection criteria and describe in detail the project’s goal, objectives, and activities.

Please see the 2021 SSH NOFO for specific information about selection criteria.

2. Application deadline: The submission deadline for the 2021 Ambassador’s SSH Program is 31 March, 2021.

· Any application that is incomplete or missing required documentation will not be considered.

· Applicants may be asked to provide additional information or clarify certain aspects.

· Short-listed applicants will be contacted with follow-on questions or potentially to schedule a pre-award site visit.

· Applicants that are not short-listed will be notified of their non-selection with a form letter.

3. Submission of the Application Package: Please email applications (as a Microsoft Word and Excel files) to Kampalaselfhelp@state.gov

Please note: We will only accept applications submitted via email to the above email address. Please submit forms in Word/Excel format; do NOT PDF.

4. Selection: The U.S. Embassy’s Grants Committee will review all submissions and short-listed candidates will be contacted with requests for additional information and may be asked to submit additional information.

5. Response to Submissions: All submissions are reviewed in a competitive and transparent manner. Due to the high volume of submissions, we will only contact short-listed applicants for more information. Those applicants may be asked to provide additional information or clarification and must respond in a timely manner to continue to be considered. We will contact those projects that are short-listed; unsuccessful projects will be sent a form letter. We cannot give detailed feedback to each unsuccessful applicant. Application forms will not be returned; please keep a copy for your own records.

In case of any questions, please contact the Small Grants Office, U.S. Mission Uganda: kampalaselfhelp@state.gov

APPLICATION FORM

Section 1:

1. Name of Organization:

2. Organization’s Addresses:

3. Title of Proposed Project:

4. Location of Project: Project District/Sub-county/Parish

5. Name of Organization’s Director: Include full name (Family name, First Name, Middle Initial), phone number(s), and email address(es) for Director. Email addresses are NOT optional.

6. Project Manager/ Coordinator/Contact Person(s): Include full name (Family name, First Name, Middle Initial), phone number(s), and email address(es) for Project Manager/Coordinator. Email addresses are NOT optional.

7. Mobile Number(s) and Office Number:

8. Total Estimated Cost of the Proposed Project in Dollars and Ugandan Shillings The total cost of the proposed project should be between $5,000 - $10,000 using an exchange rate of 3,500 UGX per $1 USD. Please note: actual funding will be given in USD; the bank facility of each organization will determine the exchange rate.:

9. Number of Beneficiaries:

10. Estimated Time to Complete the Project (3 - 12 months):

11. Previous Funding:

Please list all prior contributions to your organization, including funds provided by the Ugandan government. Add more lines as is necessary.

Section 2: Project Description

Please note: each question in this part of the application should be limited to 200 words or less. Be concise and specific. Applications that do not follow these instructions and format will not be considered.

1. Project Idea and Impact on Target Group: (no more than 200 words)

2. Brief Description of Beneficiary Selection: (no more than 200 words)

3. Project Goal:

Objective 1: (no more than 200 words for each objective, summary, and evaluation description) Summary of activities:

How will you evaluate the success of this objective?

Objective 2: (no more than 200 words for each objective, summary, and evaluation description)

Summary of activities

How will you evaluate the success of this objective?

Objective 3: (no more than 200 words for each objective, summary, and evaluation description)

Summary of activities:

How will you evaluate the success of this objective?

Objective 4: (no more than 200 words for each objective, summary, and evaluation description)

Summary of activities:

How will you evaluate the success of this objective?

4. Why is your organization best positioned to do this project (history, capacity, etc): (no more than 200 words)

5. The best projects are those the endure beyond the grant period. How will your project be sustained? (no more than 200 words)

6. Ambassador’s Small Grant Program receives hundreds of applications each year for projects that build community capacity. Please describe why your project is unique, different, innovative, and creative, and why your application should be selected. (no more than 200 words)

Section 3: Project Budget

Please refer to the instructions on the first tab of the budget annex. We have provided a sample project budget. Your budget package (Annex B) includes:

a. Detailed line-item budget;

b. Budget Narrative; and

c. Activity logical framework.

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