United States Embassy Zimbabwe PD Grant Application Form 2023.pdf

PublicDiplomacyGrants-Zim@state.gov Page 1

For Official Use Only

Date Considered (m/d/y): _/_____/_____ Committee Vote: Yes / No / Further Consideration

Award Number:

U.S. Embassy Zimbabwe – Public Diplomacy Section

Grant Application Form

(1) PROPOSAL TITLE

Title of Project:

(2) CONTACT INFORMATION

Date Submitted:

Name of organization:

Physical address:

Name and Title /Role of Primary

Point of Contact:

Telephone number:

E-mail address:

Other Organization Members &

Contact Details:

mailto:PublicDiplomacyGrants-Zim@state.gov

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(3) ORGANIZATION

When was your organization established?

Legal registered status:

Unique Entity Identifier (UEI) A UEI must be attained by the application prior to application submissions Please follow instructions to this link to obtain a

UEI: www.SAM.gov registration which will generate a UEI.

SAM registration Number:

Organizations must register with

System for Award Management

(SAM) www. SAM.gov. It can take several weeks to get the required registration number.

Statement of Assurance that

Organization is an Equal

Opportunity Employer:

Our organization has a demonstrated commitment to equal opportunity employment practices and complies with non-discrimination practices to beneficiaries. Employees and beneficiaries are considered without regard to race, religion, ethnicity, gender, sexual preference, or political affiliation.

Electronic signature

Have you ever received financial assistance from an international organization or entity before? If so, please describe:

What are some of your key achievements to date?

https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.sam.gov%2F&data=04%7C01%7Cfjeldkk%40state.gov%7C8a179f425ec644553b0a08da0c446ace%7C66cf50745afe48d1a691a12b2121f44b%7C0%7C0%7C637835785239027166%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=1O%2BquRWkk5TWZ9R%2FzeWA%2BjVqSPwgts5FKs5lUXBCVGU%3D&reserved=0

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(4) PROJECT ACTIVITY

Project Summary:

Short narrative that outlines the proposed program, including program objectives and anticipated impact.

Problem Statement:

Briefly give a clear, concise, and well-supported statement of the problem to be addressed and why the proposed program is needed.

Project Goals and Objectives:

Briefly describe what the project aims to do?

A narrative discussion of what you are seeking the

U.S. Embassy Zimbabwe to monetarily support.

Please note budget information below as well.

Project Activities:

Describe the program activities and how they will help achieve the objectives.

American Component:

Describe the U.S. element ad/or partner anticipated in this proposal.

Program Methods and Design:

Describe how the program is expected to work to solve the stated problems and achieve the goals.

Program Partners:

Has the community or any individuals (e.g. local

MP, local council, district administration) been consulted and do they support the project? List the names and type of involvement of key partner organizations.

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Proposed Program Schedule and Timeline:

Include a proposed time frame for the project activities, including the approximate start-date and end-date, and locations of planned activities and events.

Program Participants and Audiences:

Describe who the intended target audiences should be for the various activity categories.

Program Monitoring and Evaluation:

Throughout the time frame of the grant, how will the activities be monitored to ensure they are happening in a timely manner, and how will the program be evaluated to make sure it is meeting the goals of the grant?

Risk Management:

Identify possible risks that may influence the running and finalization of the project (e.g., power availability, government approvals and regulations etc.)

(5) BUDGET AND PROPOER USE OF FUNDS

Budget Plan:

a) Please attach a detailed, itemized income and expenditure budget for your project. Make sure to specify the total grant amount requested from the

U.S. Embassy Zimbabwe and, other donors, as well as the total cost of implementing the project.

The budget is one of the most important features the U.S. Embassy Public Diplomacy

Grants Committee judges your project on, so please make sure you provide this detailed budget.

*NOTE*

The U.S. government does not provide assistance awards to cover administrative costs more than 10% of the amount being requested from the U.S. can go to administrative items such as salaries or overhead costs unless the organization has a NICRA.

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Sustainability:

a) Explain how the project will be sustainable beyond the funding from the U.S. Embassy

Zimbabwe.

b) Will requested funding be adequate to finish the intended activities of the project?

Support for the U.S. Mission Goals?

Please describe which one of our Public

Diplomacy Strategic mission goals in Zimbabwe your project will achieve and how.

The U.S. Embassy’s Public Diplomacy Section seeks to strengthen and build local capacities in the following areas:

• Educational and cultural exchanges,

• Support for democracy,

• Champion freedom of speech;

• Promote higher education engagement;

• Promote social inclusion and tolerance of underserved communities, such as

LGBTQI+, people living with disabilities, and minority ethnic groups; and

• Support for inclusive economy endeavors.

Promotion of U.S. Support:

Explain how your organization will highlight U.S.

support for the project, including through media engagement.