Rural and Regional Development Support to Serbia
Fund to Support Rural-Regional Initiatives
APPLICATION FORM
Project title:
To be filled in by the RRDS team
Date of receipt:
Signature:
1
1. General information
1. Partners
Lead Partner
Partner 2
Partner 3
Partner.....
2. Lead Partner's contact details for the purpose of this action
Contact person for this action:
Contact person’s email:
Address:
Telephone number: (fixed and
mobile)
3. Summary of the action (max 1 page)
Title of the action
Location (target region and
LSGs)
Duration (months)
Total budget
CHF
Requested SDC
CHF
, % of the total costs
contribution
Objectives
Target groups
Final beneficiaries
Expected results
Groups of activities
4. Financial allocation
Total budget
Requested SDC contribution
Other contribution
Requested
prefinancing
schedule
CHF
CHF
, % of the total costs
CHF
, % of the total costs
Sources (i.e. own budget, partner 2...)
of Payment 1 (40% of the grant total): insert date
Payment 2 (50% of the grant total, upon spending minimum 70%
of payment 1) insert date
Payment 3 (up to 10% of the grant total, upon approval of final
reports including audit report)
Form of security
2
2. Relevance
2.1 Describe the relevance of the Action to the priorities of the Call for Proposals (max. 1 page)
Priority 1: to strengthen the multi-stakeholder approach in targeted regional and rural regions and
their potentials in the field of manufacturing, tourism, agriculture, food processing and others
Priority 2: to improve economic, social and environmental situation in targeted regions
Priority 3: to promote involvement of women and youth
2.2 Provide analysis of problems to be addressed on the level of initiative / region (max. 1 page)
2.3 How does the Action fits into the Initiative Action Plan (max. 1/3 page)
2.4 Define the target groups and final beneficiaries, their needs and constraints, and state how the
action will address these needs (max. 1 page)
2.5 Particular value-added elements – indicate any specific value-added elements, such as
innovative approach, public-private partnerships, environmental issues, rights of minorities, etc.
(max. 1/2 page)
2.6 Particular good governance elements – indicate any specific elements, such as participation,
consultation, transparency tools, etc. (max. 1/2 page)
3
3. Action
3.1 Define measurable objectives of the project. What is to be achieved? (max. 1 page)
3.2 Describe activities (or work packages) proposed and specify related expected outputs,
outcome(s) and impact including a description of linkages/relationships between activity clusters
(max. 5 pages)
3.3 In case proposed Action includes purchase of equipment, please detail how the equipment
contributes to the achievement of the objectives of the Initiative and proposed project, include
specification of equipment, provide an overview of specific needs of beneficiaries to be addressed
with purchase of proposed equipment, potential number of equipment users, improvement (e.g.
new business generation, increased revenues, improved productivity, quality, job creation) that will
be achieved, in figures, through purchase of equipment and the management and maintenance plan
(during and after project expires).
In addition, indicate, if applicable: safety measures; in case equipment will be shared by different end
users, how will the process be coordinated and organized and equipment storage arrangements.
3.4. In case proposed Action includes infrastructure investment, please provide an overview of all
available project spatial and technical documentation for all planned infrastructure investment. In
addition, please list all the technical documentation that has to be developed to make the
investment being mature for financing and implementation. If the proposed action includes
development of the technical study for any infrastructure investment, please submit an overview of
available technical documentation with the information when it is developed and who has developed
it as well as how it is in line with the current law on construction and whether the available technical
documentation should be revised.
3.5 Contribution and role of partners - Explain why have you chosen the proposed partnership? How
will they contribute to achievement of the project outputs? Describe the role of each partner. (max.
1 page)
3.6 Co-financing - did you propose this project for co-funding to any other international programmes
or donors? If yes, provide the information about the funding institution and programme/fund.
Have you and your partner(s) already made any arrangements to secure national/regional public cofunding of the project? If yes, name the body/institution that will provide co-funding.
3.7 Indicative action plan for implementing the action – please fill in the table below and include
information for the whole implementation period.
Total number of months proposed:
Half-year 1
Activity
1
2
3
4
Half-year 2
5 6
7 8
9
10
11
12
13
14
15
Implementing body
Example
4
Preparation
Activity 1 (title)
Execution Activity
1 (title)
Preparation
Activity 2 (title)
Etc.
5
4. Sustainability
4.1 List main preconditions and assumptions during and after implementation phase (max.1page)
4.2 Expected impact – please tick boxes below, add more rows where applicable
Expected economic impact
Improving economic situation in related area
Generation of innovative solutions based on local natural, technical and human resources
Improvement of the tourist offer and its visibility
Improvement of agricultural production/processing/marketing
Valorisation of traditional crafts etc.
Improvement of employability in area
Expected social impact
Social inclusion of women and youth
Strengthening of the cultural identity, conservation of traditional heritage
Improvement of cooperation in thematic fields of strengths
Expected environmental impact
Nature protection and preservation of biodiversity
Efficient use of energy
Increase in the use of renewable energy
4.3
Explain how the action will be made sustainable after completion. This may include
necessary follow-up activities, built-in strategies, ownership, communication plan, etc. (max. 1,5
page)
Distinguish between four types of sustainability:
a. Financial sustainability: e.g. financing of follow-up activities, sources of revenue for
covering all future operating and maintenance costs.
b. Institutional sustainability: e.g. structures that would allow the results of the action to
continue to be in place after the end of the action, capacity building, agreements and local
‘ownership’ of action outcomes.
c. Policy level sustainability: e.g., where applicable, structural impact (improved legislation,
consistency with existing frameworks, codes of conduct, or methods).
d. Environmental sustainability: what impact will the action have on the environment — have
conditions been put in place to avoid negative effects on the natural resources on which
the action depends and on the broader natural environment?
6
5. Project Partnership
5.1 Lead Partner
Name
Legal form
Address
Street, no.
Town/city
Postal Code
Responsible person
Name
Position
Phone No.
E-mail
Contact person
Name
Phone no.
Mobile phone no.
E-mail
Bank information
Name of account holder
Name of the Bank
Address of the bank
SWIFT
IBAN
Bank account No.
5.2 Project Partners
Name
Legal form
Address
Street, no.
Town/city
Postal Code
Responsible person
Name
Position
Phone No.
E-mail
Contact person
Name
Phone no.
Mobile phone no.
E-mail
Please copy the above fields to provide data for each additional Partner (Partner 2, …n).
7
6. Declaration by the Lead Partner
The Lead Partner, represented by the undersigned, being the authorised signatory of the Lead
Partner, in the context of the present call for proposals, representing all partners in the proposed
action, hereby declares that:






the Partners have sufficient financial capacity to carry out the proposed action or work
programme;
the Lead Partner certifies the legal statues of the Lead Partner and all Partners is as reported
in part 6 of this application;
the Lead Partner undertakes to comply with the principles of good partnership practice;
the Lead Partner is directly responsible for the preparation, management and
implementation of the action;
the Lead Partner and each Partner are eligible in accordance with the criteria set out under
Sections 2.1. of the guidelines for applicants;
if recommended to be awarded a grant, the Lead Partner and Partners accept the contractual
conditions as laid down in the standard grant contract annexed to the guidelines.
Signed and stamped on behalf of the Lead Partner
Name
Signature
Position
Date
8
7. Annexes
1. Annex 1 - Budget
Please list other annexes included.
9