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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