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Project Application Form and Reporting Form
Step
1
of
3
33%
Part A: Organisation | Individual Profile
Organisation | Individual Name
*
Service Provided
*
(Musician, Author, Sevice Club, NGO, etc.)
*
Contact Person(s)
Mobile Number(s)
Email Address
*
Website
Leadership Details
Leadership Details
*
Position
Individual Name
Mobile Number
Email Address
Membership Details
How many members?
*
How many are active?
*
List any project/events you have been involved in over the last six (6) months
*
If the organisation is less than 1 year old, list any projects/events since inception
Part B: Project Details
Project Title | Description
*
Project Objectives:
*
What are you trying to achieve? | Objectives must be measurable
Project Duration
Planning Time
*
:
Hours
Minutes
AM
PM
AM/PM
Launch Date
*
MM slash DD slash YYYY
Who is expected to benefit from this project?
If an event, include expected attendance numbers
Does the project fall into any of the following categories?
*
Job Creation
Health Education
Education and Training
HIV/AIDS Education and Prevention
Drug Use Education and Prevention
Leadership/Management Training
Business Enterprise Development
Skills Development
Sports Development
Conflict Management
Recognition of Achievement
Cultural | Artistic Preservation
Culture | Art Transmission/ Promotion
Development of Youth/Culture Organisation
Regional Networking
Sports Participation
Cultural Art Education
Literacy Arts
Other
If other, please specify
Type of support requested:
*
Administrative
Financial
Endorsement [letter or other]
Promotion [press | social media]
Consulting
Other
If other, please specify
Please provide details of support request
*
If financial support requested, please complete PART C – Funding.
Part C | Funding
Have you written/applied to any other Government department or agency for funding?
Yes
No
If yes, please provide details
Have you, or do you intend to organise any fundraising for this project?
Fundraising Activity
Date Held/ to be held
Amount raised/ to be raised
Projected Budget
Item | Service Description
Quantity Needed
Unit Cost
Total Cost
Source of Funds
Total Projected Budget
Please enter a number greater than or equal to
0
.
