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Application Form

This document is an application form for small grants from the Embassy of Ireland in Malawi. It requests information about the applicant organization, proposed project details, budget, and management. Applicants are directed to submit the application electronically along with any required documents, such as registration certificates and annual reports. The application is comprised of 6 sections requesting organizational information, project description and goals, beneficiaries, monitoring plans, and budget details. Applicants are informed that an invitation to apply does not guarantee funding and that reporting will be required if a grant is awarded.

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Oliver Mkandawire
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© © All Rights Reserved
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86 views

Application Form

This document is an application form for small grants from the Embassy of Ireland in Malawi. It requests information about the applicant organization, proposed project details, budget, and management. Applicants are directed to submit the application electronically along with any required documents, such as registration certificates and annual reports. The application is comprised of 6 sections requesting organizational information, project description and goals, beneficiaries, monitoring plans, and budget details. Applicants are informed that an invitation to apply does not guarantee funding and that reporting will be required if a grant is awarded.

Uploaded by

Oliver Mkandawire
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 6

Embassy of Ireland in Malawi

Small Grant Fund


Application Form

Please note:

 All applications should be submitted at/to [email protected], preferably in electronic format


 Applicants should read the short guide to funding provided before completing and submitting the application
 It is the responsibility of the applicant to provide all the necessary information so that an appraisal can be undertaken.
Applicants should ensure that there are no omissions and that all information is accurate.
 Where a separate Project Proposal document is submitted in addition, this should not be more than 4-6 pages.
 All sections must be completed
 An invitation to submit is not a guarantee of funding.

Section 1: Project Summary


Please keep information as brief as possible. Use this project summary as the title page of your application.
1.1 Name and Address of Applicant
Name of Organisation:

Address:

1.2 Contact Details


Contact Person(s):

Telephone: Fax Email


: :
1.3 Project title and/or brief description
(The description should briefly outline what the project is about. Max 50 words.)

1.4 Amount requested from the Embassy of Ireland


(This is the total cost of the expenditure from the proposed project. To be accompanied by a budget being submitted to the Embassy for
approval.)
Amount in Euro: Amount in
Malawi
Kwacha:
1.5 Have you ever applied for funding from the Embassy of Ireland/ Irish Aid or any other Government of Ireland
funding stream (including Misean Cara or the Irish Aid Civil Society Fund)
If yes, indicate from which funding stream and when was the funding received?
(Please indicate the name of funder; month and year received; the relevant grant reference number and grant amount received in the
last three (3) years, including grants received in the current year).

1.6 Please indicate the total amount of funding received, or revenue generated by your organisation each year, for the
past three years. Include all sources

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Section 2: Organisation Details

2.1 Name and title/position of person(s) who will responsible for the project and grant if received from the Embassy
of Ireland.
Name: 1st person 2nd person (if any)

Title/ Position held:


2.2 Nature of Organisation:
(Indicate if e.g. non-profit organisation/non-governmental organisation, institution, company etc.)

2.3 Organisation/ Company Registration


(Attach organisation’s registration documents, certificates etc.)
Organisation registered What status does the organisation
and domiciled in: hold? (NGO, company, trust/other).
(Country) Record the relevant registration
numbers.
 You MUST attach copies of any
relevant certificates from
CONGOMA & the NGO Board to
this application
2.4 Statutory Requirements e.g. Income Tax, Value Added Tax (VAT), and NGO fees
 You must Attach a current valid Tax Clearance Certificate (TCC), Tax Exempt Certificates (if any))
Is the Organisation TCC/ Other relevant document
compliant with tax and attached.
fee requirements?
[YES/ NO]
2.5 Please specify the organisation’s mandate and the overarching goal. (max 50 words)

2.6 Please describe your organisations management and governance structures. (up to 150 words)
 Attach a copy of the organisation’s constitution where relevant.
 Include the names of the current CEO or equivalent, and the chair of the board.
 Attach the minutes from the most recent meeting of the board (or equivalent)

2.7 Financial Information


Does your organisation produce an annual report?
 If you answer yes below, you must enclose a copy
[yes/no]
Does your organisation prepare an annual financial statement?
 If you answer yes below, you must include a copy of the most recent financial statement.
[yes/no]
Are the organisation’s accounts audited on an annual basis?
 If your accounts are audited, please include a copy of the most recent audit report.
[yes/no]
2.8 Bank Account Details
(Insert organisation’s bank account details below.
Account Name:
Bank Name:
Account Number:
Branch Name:

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Branch Code:
Account Currency:
(e.g. MKwa)

Section 3: The Project or Intervention

Results and Activities


3.1 What PROBLEM is this project going to address? (max 150 words)

3.2 What do you want to ACHIEVE? Insert your main objective(s), and describe the end result max 100 words.

3.3 What will the project actually DO? Insert your main project activities, max 100 words. Has your organisation done anything
like this before?

3.4 Sustainability. How will any activities started by the project be continued once funding is exhausted? How will any
assets constructed or procured be controlled and maintained? Max 75 words

3.5 Cross-Cutting issues - How will this project affect local power dynamics, the physical environment, gender
inequality, and the quality of life for people living with HIV & AIDS. Max 100 words

3.6 Where will the project be implemented (location)?


(Country, Town/City)

3.7 Will there be other partners involved?


(If yes, give details and their role to the project.)

3.8 Duration of the project.


(When do you plan to Start and End the project activities?)
Start Date: End:
(DD/MM/YYYY) (DD/MM/
YYYY)
3.9 List the key personnel that will be involved in the delivery of the project (as e.g. staff, volunteers, government
representatives, or contractors etc) giving a brief overview of their roles and relevant experience.

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Section 4. The People: women/girls and men/boys

Who will benefit from the project? How many people will benefit directly from the project? (include the
4.1 demographics (where possible) of the project beneficiaries/ target groups) max 50 words

Where children will be involved, what measures are in place to ensure their rights are fully protected and they
4.2 are not at risk from exploitation of any sort by the staff, participants, or any other persons associated with the
project? Max 75 wo.
 If the organisation has a written policy on child protection please enclose a copy. Max 75 words.

4.3 Where other vulnerable groups are involved, what measures are in place to ensure their rights are fully
protected and they are not at risk from exploitation of any sort by the staff, participants, or any other persons
associated with the project? Max 75 words.
 If the organisation has a code of conduct or written policy on beneficiary protection please enclose a copy.
Max 75 words.

Section 5: Monitoring

5.1 How will the project activities be monitored?

5.2 How will the project’s results be measured - and by whom?

5.3 How will the project’s expenditure be monitored (how often and by whom)

Note: If successful, recipients will be required to submit a Narrative and Expenditure Report no later than 3 months after the
end of the project.
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Section 6: Project Budget and Management

6.1 Insert details of the project’s budget here. This budget format may be expanded as necessary. For activity related
expenses such as training insert the cost per person trained

Item Unit cost Number of units Total cost MKWA Total Cost EURO

Totals

6.2 Are there Financial contributions from your organisation, the community, or other donor towards the project?
If yes, provide details.

6.3 Describe how PROCUREMENT (purchases) will be undertaken. What measures will be taken to ensure value for
money is achieved for the project?

6.4 Describe how expenditure will be recorded (ledger, online accounts system etc).

Note: If successful, recipients will be required to submit a Financial Report reporting Actual expenditure analysed against the
approved Budget. Submission should be done by no later than 3 months after the end of the project.

Freedom of Information Act


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Any information provided by you in this application may be subject to release under the Freedom of Information Act of 21 April
1998. If you believe that any of the information supplied by you should not be disclosed because of its sensitivity, you should
identify this information and state the reasons for its sensitivity. The Department of Foreign Affairs/ The Embassy of Ireland
will consult with you about this sensitive information before making a decision on any Freedom of Information request
received.

Declaration

I/We the undersigned, certify that the details contained in this application are correct and I/we
undertake to provide any additional information which may be required in support of the application.

Name:_______________________________ Name:__________________________________
_ _

Signature:____________________________ Signature:_______________________________
_ _

Title: Title:

Date: Date:

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