Feedtheminds Foundation Application Form – Fill Out and Use This PDF

Small Grant Application Form £1,000-£10,000 spread over 1-3 years

Please read instructions at the end of this application form before completing it

A. YOUR ORGANISATION

1. Name of organisation

Including acronym or abbreviation (if any)

2.When was your organisation established? Including month and year

3.Full name of contact person Including title (Dr/Mr/Mrs/Ms/Rev)

4.Full postal address of organisation

5.Full physical address of organisation (if different from postal address)

6.Telephone number

Including country and city codes

7.Fax number (if applicable) Including country and city codes

8.Email/s Most contact from Feed the Minds will be through email

9.Website (if applicable)

10.Main aims and objectives of your organisation a) What does your organisation exist to achieve?

b)Who are the key target groups you work with?

c)Vision, mission or values statement (if applicable)

11. What major projects have been carried out by your organisation in the last two years?

Year	Project title	Budget in £GBP	Source of funding

1	September 2009

Small Grant Application Form £1,000-£10,000 spread over 1-3 years

		12. Has your organisation had previous
		funding from Feed the Minds?
		If yes, please give details including dates,
		amount of funding, project title and
		reference number (if applicable)
		13. How does your organisation fund
		its activities?
		Please include other donors and local
		contribution (if applicable)
		14. What is the annual turnover of your		Exchange Rate			£1 =
		organisation in £GBP?				Year					Annual turnover
										£
										£
		15. What is the structure of your
		organisation?
		Please describe the management
		structure including information on the
		governing/trustee body (if applicable), and
		number of staff.
		Please include gender breakdown
		16. How would you describe your				Non-governmental organisation (NGO)
		organisation?				Community-based organisation (CBO)
		(please tick all relevant boxes)
						Other (please specify)

17. Faith-basis - In what ways, if any, is your organisation linked with local churches or other faith-based organisations? e.g. religious leaders on your board of trustees, working with churches in delivering your programmes, receiving support from religious institutions, or religious principles influencing your work.

18. Please supply details of two external referees

e.g. other/previous donors, director of a partner organisation. Please ensure that these people are not directly connected with your organisation but are able to give an independent reference.

	First referee	Second referee
Name
Organisation
Job title
Email
Phone number
Including country and city codes
How does this person know your
organisation?
How long have they known you for?
2		September 2009

Small Grant Application Form £1,000-£10,000 spread over 1-3 years

Section B should not exceed 6 pages

Please type if possible; if handwritten ensure you provide sufficient details

B. PROPOSED PROJECT APPLICATION

1.Title of project - The title should tell the focus of the project. Please keep it brief and simple.

2.Area of implementation

a)Name of country, district or villages

b)Explain why this area was selected

3.Summary of the project in less than 100 words - Please explain the main features of your project

4. Project framework

a)Project aim - What is the overall change to which this project will contribute?

b)Project objectives - What are the intended achievements of this project?

1.

2.

3.

4.

c)Project outcomes - What will be the changes you expect to see taking place for individuals, communities and organisations?

1.

2.

3.

4.

3	September 2009

Small Grant Application Form £1,000-£10,000 spread over 1-3 years

7.Who are the intended beneficiaries of this project? Please include approximate numbers, gender, age and any other relevant categorisation. Specify direct and indirect beneficiaries.

8.Will other organisations be involved in this project? If yes, how?

9.How will the impact of the project be sustained?

Explain how the project or its impact will continue after the funding period has ended.

10. Monitoring and evaluation

Monitoring is the process of ensuring that the project meets its objectives and the activities are carried out on time and within the resources available. Evaluation is the process of measuring the effectiveness and impact of the project and the achievement of the intended outcomes.

a)Who will be responsible for monitoring and evaluation?

b)What specific activities will take place to evaluate the progress towards the project outcomes?

c)How will this information be used to benefit your organisation and the communities you work with?

11.Is this application for the continuation of an existing project? Yes/No a) How does this project build on the previous one?

b)What lessons learnt have been incorporated in the current proposal?

c)Is there an evaluation report from the previous project? (Please do not attach, this will be requested if required)

5	September 2009

Small Grant Application Form £1,000-£10,000 spread over 1-3 years

Section C - All amounts should be in £GBP.

Please provide sufficient detail on the costs associated with the project and how funds will be used. Where possible break down the costs (e.g. HIV/AIDS Training – venue, speaker fees, handouts, food).

C. BUDGET - please add more lines as necessary

Exchange rate	£1 =
Expenditure items	Anticipated		Other funders		Local	TOTAL
	expenditure		Awaiting response /		contribution
	Feed the Minds		Successful1
CAPITAL COSTS2
	£	£			£	£
	£	£			£	£
	£	£			£	£
	£	£			£	£
	£	£			£	£
Total capital costs	£	£			£	£
REVENUE COSTS3
	£	£			£	£
	£	£			£	£
	£	£			£	£
	£	£			£	£
	£	£			£	£
Total revenue costs	£	£			£	£
TOTAL BUDGET	£	£			£	£
Any additional information on budget
If your budget includes the purchase of
equipment or other capital costs you should
provide justification for this here.
Amount sought from	£
Feed the Minds
Authorised by	Name:
	Position:
	Date:

1Please give details if you have applied for funding from other sources and are awaiting a response or successful.

2Capital costs are costs for the purchase of goods which will outlast the length of the project. They are costs for things that will not be used up during the length of the project and so will provide infrastructure or equipment that the organisation will retain once the project has ended. Examples include, but are not limited to, buildings, vehicles, computers, equipment such as printing presses, blackboards, furniture, etc. Limited funds means that Feed the Minds is unable to fund projects which include more than 15% for capital costs.

3Revenue costs are all costs associated with the purchase of goods or services which will be consumed within the course of the project. Examples include staff time, administrative costs, transport, consumable materials such as paper or pens, venue hire, etc.

6	September 2009