Application Form For Project Financing

Application form for project financing
You can use this application form to submit your projectproposal. To be able to assess your request,
please complete allthe fieldsin the right column andattach the required documents. Takeinto account
that the decision-making procedure can take up to 4 monthsand not all requests will be accepted. We
will send you a letter of receipt as soon as we have received your application.
If we approve your project, you will receive a financial contribution. After this payment, we will expect
you to carry out the project as planned, and keep a clear account of your finances. We also expect to
receive an evaluation with regard to the progress halfway through and at the end of the project. This
evaluation should include a financial report and some photographs of the project. We will send you the
forms to use in due time. . We wish you good luck with your application!
A. Project information
A1. Project name
A2. Desired start and end date of the project: Start date:
(Please allow 4 months for the assessment of End date:

this request)
B. Information applicant group or organisation
B2. Name of group or organisation that submits

the application:
B2. Address ofgroup or organisation: Town:

Street:
Region/District:
Country:
B3. Contact person: Name:

E-mail address:
Phone number:
B4. Type of group or organisation:

(E.g. Self-support group, official women’s group,
NGO, religious organisation, etc.)
B5. Goal(s) of the group or organisation:
B6. Has the group or organisation been Yes / No

registered officially?
If yes: at which authority? Authority:

Registration number:
Please attach a copy of the registration to this
application form
B7.1 How many members are there in the Number of people:

committee of your group or organisation?
B7.2. How many of these members are women? Number of women:
B8. Bank account information of the group or Name of bank:

organisation Address bank:
Bank account number:
BIC/SWIFT-code of the bank:
Name(s) of bank account holder(s):
Please attach a copy of a bank statement to this

applicationform as a confirmation of the bank
account information.
C. Project description
C1. Please describe your project in max.10

sentences.
C2.1 Which women or girls will benefit C2.1.

directlyfrom the results of this project
(beneficiaries)?
C2.2.
C2.2. How many women or girls will benefit
directly?
C2.3.
C2.3. Which women or girls will benefit indirectly
from this project?
C2.4.
C2.4. How many women or girls will benefit
indirectly?
C3.Principalgoalof the project.
Is your project’s main goal to increase women’s Increasing income / other

income, or does it have a different goal?
If something else: please specify.
C4. What are possible secondary goals of the

project?
(For example: strengthening of the organisation,

climateimprovement,increasing knowledge and
skills of women, encouragement of
independency, improving children’s health, or
improving agricultural production ...)
C5. Will the project include the purchase of Yes / No
materials or tools?
If yes: which materials or tools?
C6. Will your project include training activities or Yes / No

other type of knowledge sharing?
If yes:
What type of training?
How often will these activities take

place?
How many women will participate each

time?
D. The beneficiaries
D1. Please describe in up to 5 sentences the

beneficiaries this project is aiming at. Please
describe the following:
Average age, urban/rural life, important daily

activities, profession, income level, knowledge
and skills, etc.
D2. What are the main problems that the

beneficiary group faces?
E. Required budget
E1. How much funding will your project require? E1
E1.1. What is the amount that you request from E1.1.

Melania?
E1.2. How much can your group or organisation E1.2.

contribute?
E2. Please indicate in appendix 1 how you plan See: Appendix 1

to allocate the funds from Melania.
Please add a quotation for any materials
required.
F. Project experience and references
F1. Has the applicant group or organisation Yes / No

carried out a project in the past?
If yes: did you use your own finances, Own financing / external financing / both
was there external financing or both?
F2. Can you list an organisation Melania can ask Yes / No

for a reference? This could be a previous project
sponsor or a development agency.
If so: Please fill in the name and address of this
organisation:
F3. Are the beneficiaries of your project currently Yes / No

being supported or financed by another
organisation?
If so:
Which organisation?
How are they supported?
Give your consent to use photos and videos
In order to find donors, Melania should be able to show what is happening in her projects. Future
donor groups appreciate receiving photos and videos in due time.
Therefore, if your application is accepted by us, we will ask you to give us your consent to distribute
photos or videos of your project to the donor group and/or use itas promotional material for Melania.
Signature
By signing this application form you will confirm that you have completed ittruthfully, that you
understand the obligations of transparant project management, and that you agree tocomplete a
mid-termand a final report.
Date Name andsignature
Project number To be filled in by Melania after approval of the

application.
Appendix 1. Budget specification
Description (1) Amount Price per item (in Total price (in Total price (in
local currency) local currency) euro’s)
Purchase of
materials
Transportation
costs
Training costs
Othercosts
Total

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Application form for project financing

A1. Project name

(Please allow 4 months for the assessment of End date:

B. Information applicant group or organisation

B2. Name of group or organisation that submits

B2. Address ofgroup or organisation: Town:

B3. Contact person: Name:

B4. Type of group or organisation:

B5. Goal(s) of the group or organisation:

B6. Has the group or organisation been Yes / No

If yes: at which authority? Authority:

B7.1 How many members are there in the Number of people:

B7.2. How many of these members are women? Number of women:

B8. Bank account information of the group or Name of bank:

Please attach a copy of a bank statement to this

C1. Please describe your project in max.10

C2.1 Which women or girls will benefit C2.1.

C3.Principalgoalof the project.

Is your project’s main goal to increase women’s Increasing income / other

If something else: please specify.

C4. What are possible secondary goals of the

(For example: strengthening of the organisation,

If yes: which materials or tools?

C6. Will your project include training activities or Yes / No

How often will these activities take

How many women will participate each

D1. Please describe in up to 5 sentences the

Average age, urban/rural life, important daily

D2. What are the main problems that the

E1. How much funding will your project require? E1

E1.1. What is the amount that you request from E1.1.

E1.2. How much can your group or organisation E1.2.

E2. Please indicate in appendix 1 how you plan See: Appendix 1

F. Project experience and references

F1. Has the applicant group or organisation Yes / No

F2. Can you list an organisation Melania can ask Yes / No

F3. Are the beneficiaries of your project currently Yes / No

Give your consent to use photos and videos

Date Name andsignature

Project number To be filled in by Melania after approval of the

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