Download project information - National Environment and Planning Agency

ALTERNATIVE LIVELIHOOD GRANT APPLICATION FORM
APPLICANT SUMMARY
Table 1: Applicant’s Contact Information
GOVERNMENT ENTITY RESPONSIBLE
FOR THE PROTECTED AREA
Name of Government Entity:
GRANT APPLICANT/COOPERATING
ORGANIZATION
Name of Organization:
Address:
Address:
Telephone:
Telephone:
Fax:
Fax:
Email:
Email:
Contact Person:
Contact Person:
Position of contact person:
Position of contact person:
Amount Requested from GRANT FUND J$______
Total Project Cost J$ ______
Co-funding information if applicable (including value of in-kind contribution).
PROJECT INFORMATION
PROJECT TITLE
(Reflect the essence of the project in as few words as possible)
PROJECT START DATE AND END DATE
(Project duration must be for 5 months or less)
PROJECT LOCATION
(Town & Parish and Protected Area where it is located)
PROJECT SUMMARY: (1-2 pages maximum)
(Describe the main purpose, objectives and components of the project. This section should provide a concise and clear summary of the
Project.)
1
BACKGROUND: (1-2 pages maximum)
(Identify the problem that the project seeks to address, relating it to the overall priorities of the lead entity and the NPAS project outcomes ).
OBJECTIVES:
(List the primary objectives of the project that address the problem stated. Also list associated activities and indicators that will prove your
activities have been completed successfully. Please do not list more than two (2) objectives. You may however have more than one activity
associated with each objective. Objectives must be Specific, Measurable, Achievable, Realistic & Time bound (SMART). Indicators must be
related to relevant NPAS Project outputs. They must be measurable and appropriate for monitoring and evaluation during and at the end of
the Project.)
Table 2 – Project Objectives, Activities, Outputs and Indicators
Project Objectives
Activities
Outputs
Indicators
1
2
METHODOLOGY
(Give a detailed description of the approach or technique(s) to be used to accomplish the project objectives. Ensure you give ALL THE STEPS
to implementing the project.)
PROJECT SUSTAINABILITY & RELEVANCE TO CLIMATE CHANGE
ADAPTATION PROJECT (SPECIFICALLY ALTERNATIVE
LIVELIHOODS):
(1 -3 pages maximum)
(Indicate how Project results will be sustained after the Project Period has ended and where appropriate; indicate for how long results will be
expected to have an impact. Indicate how project results will be disseminated. Outline the relevance of the project with the specific outputs of
the Alternative livelihood program under Climate Change Adaptation Project)
PROJECT MANAGEMENT & ADMINISTRATION
(Indicate Project Management arrangements that will facilitate successful Project completion. Outline the implementing organisation’s
strengths& weaknesses for supporting the project. Does the organisation have the capacity to implement this project?)
COLLABORATIONS & PARTNERSHIPS
Indicate the organisations/agencies (NGOs, CBOs, institutions or Government Agencies) with which you propose to collaborate. What will
each organisation/agency contribute to the project? Are there any volunteers or in-kind partnerships? Provide evidence of such commitments.
Are permits or licenses necessary for the project? Have the relevant authorities endorsed the project?
2
PROJECT BUDGET SUMMARY
No ITEMS
REQUESTED
APPLICANTS
OTHER
Notes to the budget
GRANT AMT. CONTRIBUTION CONTRIBUTIONS
J$
J$
J$
Please state in Give indication of Funds from other
All budgets to be
whole numbers funds being made
donors/projects.
presented in Jamaican
rounded off to
available for
Indicate if funds are
dollars
the nearest
project (inin place or to be
hundred.
kind/cash).
approved.
Please annotate your
budget where
appropriate
1 Project
Activities
2 Accommodation
3 Materials,
Equipment,
Tools &/or
Appliances
4 Transportation
5 Stipend –
Community
members
6 Stationery &/or
supplies)
Detailed breakdown
attached to show types
of activities. Breakdown
per activity and show
cost for venue,
refreshment, materials &
equipment etc. specific
to each activity
Pro-forma can be
included)
e.g. fuel (where
appropriate)
If applicable
7 Other (please
indicate)
8 Other (please
indicate)
9 Other (please
indicate)
TOTAL
Budget Assumptions: In the detailed budget attached, please indicate the basis of the estimated costs for each of
the main line items in the budget – that is:
a.
Unit price e.g. cost per dozen, per person, and
b.
Attach copy of quotations/estimates and/or Pro-forma invoices when possible
3
PROJECT IMPLEMENTATION SCHEDULE
NO.
(#)
PLANNED ACTIVITIES FOR
PROJECT
TIMELINE (MONTHS)
1
2
3
4
5
4