Grants Application Form

U.S. Embassy, Dhaka

Public Affairs Section,

U.S. Embassy Dhaka
J Block, Progoti Sharoni
Notun Bazar, Baridhara, Dhaka
T: (88-02) 5566-2802
Email: [email protected]
Website: https://bd.usembassy.gov/
 Grant Application Form

U.S. Embassy Dhaka

Note: Applicants are encouraged to use as much space as needed for their responses
and not limit themselves to the space given under each category. If you need more
space, please feel free to attach additional pages.

1. Date of Application:

Section A: The Organization

2. Contact Information

a. Name of Applicant Organization:

b. Type of Organization (NGO/Non-
Profit/Foundation/Trust/CBO/Educational
Institution
c. Name of Head of Organization
d. Postal Address:
e. Office Phone Number:
f. Cell Number:
g. Fax:
h. Email:
i. Organizational Website:
j. 2nd Contact Person for Applicant
Organization (name & designation):
k. Cell Number:

3. Date of establishment of organization*:

*This will be the date of registration in Bangladesh; please attach a copy of your
registration certificate. Your organization must be legally registered in Bangladesh for
a minimum of six months to be eligible to apply for funding. Applicant organizations
are also required to obtain U.S. Government registrations (see Section 7 below).

4. Legal Status:

Are you legally registered in Bangladesh? Yes

No

2
 If yes, please attach a copy of your registration certificate(s).

If no, have you applied for registration in Bangladesh? Yes

No

5. Details of Ongoing & Completed Projects (donor-funded)

Going back three years, please list your organization’s ongoing and completed
projects. Start with the most recent projects and feel free to add rows to the
bottom of the table if you need more space.
Project Name Donor/Fundin Major Activities Project Total
g Source Duration Budget
(From – To) (BDT)

6. Details of previous projects funded by U.S. Embassy, Dhaka (for

example, Public Affairs Section, Pol/Econ Section,
USAID/Bangladesh, etc.)

Has your organization received a U.S. Government grant before? Yes

No
Date of Award Amount (USD) Purpose of Award
Award

7. Details of Registration in U.S. Government Systems

Organizations that apply for assistance from U. S. Embassy,

Dhaka must obtain the required U.S. Government registrations. First,
organizations need a Unique Federal Identifier (UFI), which is known as a
DUNS Number (Data Universal Number System). After you have received
your DUNS Number, please insert it below. Second, applicants must
obtain an N-CAGE (NATO Commercial and Government Entity) Code. After
you have received your N-CAGE Code, please insert it below. Third,
register in SAM (System for Award Management), and obtain proof of
application.

3
Only two registrations – a DUNS Number and an N-CAGE Code – are required
at the time of application. However, all three registrations – DUNS, N-CAGE
and SAM – are required before any grant can be awarded.

All registrations are free of charge. Any additional services offered during the
registration processes are not necessary and applicants are under no
obligation to sign up for them.

To obtain a DUNS Number, go to http://fedgov.dnb.com/webform/newReq.do.

N-CAGE registration information is available at
https://eportal.nspa.nato.int/AC135Public/scage/CageList.aspx. To register in
SAM, visit www.sam.gov. A video and instruction manual (pdf) containing
step-by-step instructions for meeting these registration requirements can be
found on the U.S. Embassy Dhaka website (click here).

Please answer the following:

a) Does your organization have a DUNS Number? Yes No

If yes, please provide the number:

b) Does your organization have an N-CAGE Code? Yes No

If yes, please provide the code:

c) Does your organization have an active registration in SAM?

Yes No In process

If yes, please provide proof of registration (the email confirmation of

registration, or snapshot of organizational overview page from SAM).

8. Administrative Requirements

Organizations that are selected for funding must have a bank account that is
able to receive U.S. Government (USG) funds. It is preferred that this bank
account be for the grantee organization and not be an individual or personal
bank account. Grant recipients will be expected to provide periodic bank
statements that show how the USG funds are being used.

Does your organization currently have a bank account? Yes

No

If yes, who is responsible for your bank account or has access to your
bank account?
Name(s) & Designation(s):

If no, would your organization be able to open a bank account if it were

selected for funding? Yes No

4
Section B: Proposed Project

Project Title:

Project Cost: How much funding are you requesting from U.S. Embassy Dhaka?
(BDT Amount)
(USD Amount)

(Note: Rate of Exchange is 82 BDT = 1 USD)

Focus Area/Sectors: Please tick () all relevant box(es). You may check
more than one box.
Democratic reform and good Entrepreneurship
governance

Human rights, tolerance and non- Environment

violence

Education (formal or informal) Arts and culture

Priority/Target Populations: Please tick () all relevant box(es). You may
check more than one box.
Youth Women and Girls

Underrepresented/Underprivileged Other populations

Groups
Please identify:

Project Location:

Division District Sub-District/Upazila

5
1. Project Summary/Overview:

Please provide a brief summary of your proposal (one paragraph). Be sure to

include the overall goals of the project, mentioning who will be involved, what
activities will be done, and who will be impacted or benefit. Please provide as
much quantifiable information as possible.

2. Project Rationale:

Why is this project needed? Briefly describe the situation or circumstances

that have created the need for the proposed project. Proposed projects should
be demand-oriented and meet the actual needs of the priority/target
population(s).

3. Project Goals and Objectives

What results will this project achieve? Please describe the project’s goal(s)
and objective(s).

6
Project Goal(s):

Project Objective(s):

4. Proposed Project Beneficiaries

Who will directly benefit from your project? Which types of people/population
groups will be targeted for capacity building? State the number of projected
beneficiaries and separate them by gender. Note: Categories should indicate
specific demographics such as under age 18/over age 18, women, youth,
academicians, professionals, or underrepresented/underserved individuals,
etc.

Category 1 Category 2 Category 3 Category 4 Total

Male Example:
20 youth
under age
18
Female

5. Project Activities & Timeline

How and when will the grant award be used? First, list your key project
activities. Second, provide a clear, step-by-step timeline for your project.

Note: Project activities and implementation timeline should be presented in a simple

chart. Here are two examples:

Timeline in Months
Activity/Milestone
1 2 3 4 5 6 7 8 9 10 11 12
Activity A √ √
Activity B √ √
Activity C √ √ √ √
Activity D √ √ √ √ √

7
(OR)

Activity Proposed start Expected completion

date date
Activity A
Activity B
Activity C
Activity D

6. Details of the Proposed Team for Project Implementation

Please provide information about the staff members who will be responsible
for implementing and overseeing the proposed project. Please also attach CVs
for these staff members/volunteers, which are not more than two (2) pages
each and indicate the person’s relevant skills and experience.

Name Title Proposed Role Total Working

Experience with
Your Organization

7. Itemized Budget Details of the Proposed Project:

An itemized budget is an essential component of the grant application and a

critical element in determining applicant eligibility. We ask that you carefully
read the instructions provided in the attached budget template and submit an
itemized budget using the given format. “Lump-sum” budgets that are
not broken down into line items, costs per unit, and total costs, etc.
will not be considered for funding.

Instructions for Budget Preparation:

 Applicants are encouraged to “cost-share” through in-kind contributions. If
your organization would like to share some of the project costs, please
explain in what form this contribution will be provided (e.g., labor
[staff/volunteers] or materials).

 If you have – or plan to solicit – private partners to support your project,

please describe this in detail. Please also attach any letters of support that
detail project contributions from private organizations.

8
 Provide a detailed breakdown of the project activities as mentioned in the
project proposal, and provide a separate budget line item for each of your
activities.

 Applicants may include indirect costs – also known as “overhead” costs – in

their budget requests. These costs can be up to 10%. Requests for
overhead costs that exceed 10% of the grant request will not be
considered for funding.

 U.S. Embassy, Dhaka assumes that grant applicants will already be in

operation, and have adequate staff/volunteers and most of the capacity
required to accomplish their project goals and objectives.

 In some cases and where justified, project staff salaries and travel, as well
as equipment and operating expenses such as vehicle rental and fuel costs,
may be permitted as direct project implementation costs.

 Budget requests must be in U.S. Dollars with corresponding columns for the
equivalent amounts in Bangladesh Taka. The rate of exchange used by U.S.
Embassy Dhaka is constant at 82 BDT = 1 USD.

 Please provide budget justifications where needed.

9
Section C: Frequently Asked Questions

1) Q. Our organization would like to submit supplemental materials

with our project proposal. How should we send them?
A. Please submit only the requested documents as outlined in Section D,
“Application Checklist.” We are not able to accept samples, prototypes,
or other supplementary materials as part of your funding request.

2) Q. If our organization applies for a grant of $25,000 and the

Grants Review and Selection Committee approves our request,
can we expect to receive the full amount?
A. No. Being selected for funding does not guarantee that your
organization will automatically receive the full amount it requested.
Grant awards depend on a number of factors, including the availability
of funds.

3) Q. Our organization has already received a grant from U.S.

Embassy Dhaka’s. Can we apply for a grant again this year?
A. U.S. Embassy, Dhaka gives preference to new applicants, but the
Grants Review and Selection Committee will review each project
thoroughly, and determine which proposals best meets the goals and
priorities of U.S. Embassy Dhaka.

4) Q. Our organization’s funding request does not fall under any of

your stated priorities. Can we still apply for a grant?
A. U.S. Embassy, Dhaka does not award grants to projects or activities
that fall outside of its funding priorities.

5) Q. I am an individual seeking financial assistance. Am I eligible

for a grant?
A. No. As stated in the Notice of Funding Opportunity, U.S. Embassy,
Dhaka funding is only available to non-governmental organizations,
non-profit organizations, foundations, trusts, community-based
organizations and educational institutions that are legally registered in
Bangladesh.

6) Q. Does our organization need to have a DUNS Number, obtain

an N-CAGE Code, and register in SAM before applying for a
grant?
A. Your organization must obtain a DUNS Number and an N-CAGE
before applying for a grant from U.S. Embassy, Dhaka. If selected for a
grant award, your organization will not be able to receive any
funding unless and until it acquires SAM registration in addition to a
DUNS Number and N-CAGE Code.

10
11
Section D: Applicant Declaration
S. Statements Ye No
No. s
1. The organization has or will obtain DUNS, N-CAGE and SAM
registrations prior to receiving any grant award.
2. The applicant organization will comply with U.S. Embassy
Dhaka’s reporting requirements.
3. The organization will fully comply with U.S. Embassy
Dhaka’s branding/marking and publicity requirements as
explained in U.S. Department of State Identity and Marking
Standards (available on the U.S. Embassy Dhaka website).

Section E: Application Checklist

S. Required Documents & Assurances Ye No
No. s
1. All sections of the application have been completed as
instructed.
2. A copy of the organization’s registration certificate is
attached.
3. CVs of the proposed project’s team members are attached.

4. A detailed and itemized budget is attached.

5. The applicant organization has indicated the status of its

registration in DUNS, N-CAGE and SAM.
6. The applicant organization has indicated the availability of
a bank account.
7. In cases where the applicant organization has undergone
an external organizational evaluation in the last five years,
this report has been attached with the application.
8. If the applicant organization has implemented a project
funded by U.S. Embassy Dhaka or USAID/Bangladesh, its
project completion report has been attached. (In cases of
ongoing projects, the most recent progress report is
attached.)
9. Letters of Support (where applicable).

To the best of my knowledge, I declare that all of the above information is true and
accurate.

Sincerely,
Name: Designation:

12
Signature:
Date:
(To be signed by the Head of Organization)

13