Institutional Grant Application Form
DSP II
INSTRUCTIONS HOW TO FILL IN THE APPLICATION
This application form has a certain format, and applicant shall ensure that application will include
the following:
 Be completed in a computer;
 Be in Albanian, Serbian or English;
 No longer than 20 pages (A4), without annexes. To have an answer on each question and
section provided below;
 Grant duration cannot exceed 36 months;
 Institutional grants budget form. Do not attach other forms;
 NGO Registration Certificate;
 Declaration on the Conflict of Interest;
Application shall be submitted in one (1) original and one (1) copy of A4 format. The completed
application documents should also be submitted in electronic form (CD);
The completed applications should be submitted to KCSF offices. The wording in the envelope shall
contain the following text: “DSP institutional grant application, full name and address of
applicant”;
Applications will be received every working day, from 10:00 hrs. to 16:00 hrs.; on Fridays until 14:00
hrs.
Address for the submission of applications:
Kosovar Civil Society Foundation - KCSF
Fazli Grajçevci 4/a, 10000, Prishtina, Kosovo
APPLICATION DEADLINE
Date: 30 March 2015
Time: 16:00 hrs.
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Institutional Grant Application Form
DSP II
CHAPTER 1: Organization details
Organization details (not longer than 2 pages)
Applicant No.
To be completed by
KCSF
Application date:
To be completed by
KCSF
ORGANIZATION IDENTITY
Name of applicant:
Full legal name (acronym)
Legal status:
Foundation or Association
Registration No.
Registration No.
Establishment date:
VAT Number
Fiscal Number:
Address:
Street, Number, Postal Code, village/city
Telephone number:
Land line and mobile
Executive Director:
Name and surname - E-mail address
Website:
www.
Bank details:
Name of bank and account number
Current staff:
Number of staff members (full time, part-time, volunteers)
Budget in 3 last years
2014: EUR ...
2013: EUR ...
2012: EUR ...
Key donors:
Indicate 5 key donors as per their donations amount
Relevant experience:
Enlist three main projects related to the program1 you are applying for. (project title,
amount and implementation year)
1
Institutional support could be for a program or the entire organization.
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Institutional Grant Application Form
DSP II
KEY INFORMATION FOR THIS APPLICATION
Title of program/strategy
you are applying for:
“”
Duration:
How many months? DD/MM/YY - DD/MM/YY .
Amount requested from
DSP:
EUR ...
Location:
Indicate the region, city, village or neighborhood.
Please describe briefly in one paragraph the program/strategy goal or the expected
change.
Program/strategy goal
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Institutional Grant Application Form
DSP II
CHAPTER 2: ORGANIZATION PROFILE
 Mission (describe the mission of your organization, as defined in the Statute):
 Management structure (describe management bodies of organization and give
names of key Assembly and/or Board members, as well as its executive
management:
 Decision-making (describe the decision making for key decisions in your
organization):
 Scope (enlist not more than 3 priority activity fields of your organization):
 Short description of programs (describe key organization programs, their scope and
key activities):
 Approach to the development of programs/projects (describe how the organization
programs and projects are developed; who is involved in their designing and
implementation; how is their implementation evaluated):
 Networking (Are you a member of a formal or non-formal network in Kosovo and
abroad? If yes, please indicate).
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DSP II
CHAPTER 3: ORGANIZATION PROGRAM (for which institutional grant support
is requested)
 Description of program/strategy/activities in last 3 years (not more than 2 pages)
(When was the program launched? What projects/activities were undertaken by the
organization in the last 3 years within this program? Which were the main achievements of
the program? Which are the main challenges of the program? If newly launched program,
describe reasons for its launching and the way how it was launched?)
 Target groups (not more than 1 page)
(Who are the target groups of this program and is there any change going to happen for
these groups in case of benefiting from the DSP? Which is their role and benefit in the
development and implementation of the program?)
 Strategy and annual plan goals of the organization (not more than 1 page)
(Which are the general goals of organization strategy? Which are the goals of a specific
program you are applying for? Which will be the key achievements of specific program you
are applying for through DSP?)
 Planned activities, including implementation strategy and approach (not more than
3 pages)
(Enlist key planned activities for this program, including the strategy and implementation
approach for each activity)
 Expected results (not more than 2 pages)
(Indicate and describe the results you plan to achieve through your program activities?
Relate them to planned activities and expected results from the DSP)
 Internal quality control mechanisms (not more than 1 page)
(Describe the coordination, reporting, oversight and internal evaluation of program and
activities?)
 Risk factors and program sustainability (not more than 1 page)
(Describe risk factors that may impact the program implementation. Describe measures to
cope with these risks. How will you ensure sustainability of this program/strategy following
the end of DSP support?).
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Institutional Grant Application Form
DSP II
CHAPTER 4: EXISTING CAPACITIES OF ORGANIZATION
 Human resources:
Number of full time staff members
Number of part time staff members
Number of volunteers
 Staff member skills (Describe staff member skills and their expertise):
Name and surname
Position
Skills and expertise
Add columns if need be
 Describe technical equipment in the possession of organization:
Type of equipment
Number
Condition
Add columns if need be
 Financial situation
Indicate organization’ s annual budget for the last three years:
2012
2013
2014
 Financial Management
(Which financial management system is used by the organization? Who is responsible for
financial planning and management?):
 Capacity Building Needs
(Indicate the organization capacity building needs, including trainings, research skills,
assistance at work, strategic planning, etc.):
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DSP II
 Other important information (not more than 1 page)
(Indicate any other information not mentioned above, which you consider to be important
for a proper evaluation of your application):
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Institutional Grant Application Form
DSP II
CHAPTER 5: FUNDING
 Funding sources and amounts in last 3 years (please indicate funding amounts of
your organization in the last 3 years):
Funding
source
Total
Funding
source
category2
Funding
amount for
2012
Funding
amount for
2013
Funding
amount for
2014
% of the total
amount of
annual
budget for
2014
100%
2
E.g. membership fees, economic activity of organization, central/local government, individuals, private
company, local/international donors, etc.
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Institutional Grant Application Form
DSP II
MANDATORY ANNEXES
1.
2.
3.
4.
5.
6.
7.
8.
9.
Registration Certificate and Fiscal Number Certificate of your organization;
VAT Certificate (if available);
Organization Statute;
List of Board members and /or heads of the Assembly of Members;
Organization strategy, including the program you are applying for;
Annual Work Plan;
Resumes (CVs) of persons responsible for grant implementation;
Budget together with salary specification and reasoning;
Financial balance statements and Auditor’s reports for last two (2) years.
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Institutional Grant Application Form
DSP II
Conflict of Interest
1. Is there any conflict of interest between the organization staff members or people who will be
working with the project and members of Grants and Awards Board (GAB)?
Indicate PO or NO
2. If YES, with which GAB member you are in the conflict of interest?
Saranda Cana
Anamari Repić
Edis Agani
Ertan Munoglu
Rinor Beka
If in conflict of interest, indicate your relation
If in conflict of interest, indicate your relation
If in conflict of interest, indicate your relation
If in conflict of interest, indicate your relation
If in conflict of interest, indicate your relation
Definition:
Conflict of interest - is a situation of incompatibility between mandated duty and private interest of
a GAB member, when he/she has direct or indirect private personal or property interests that may
influence or seems to influence his/her legitimacy, transparency, objectivity and impartiality during
the discharge of Grants and Award Board (GAB) responsibilities.
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