FRENCH EMBASSY IN AFGHANISTAN
Innovative civil society and stakeholder coalition projects
(ICSSCP)
Name of NGO/Association
Contact in Afghanistan
Contact abroad
Name of the chairman :
Address :
Tel. / Fax :
E-mail :
Website :
Name of the chairman :
Address :
Tel. / Fax :
E-mail :
Website :
Status
Legal status
Date of foundation
Work field
Work country
Working in Afghanistan since
Staff
Number of employees (Please specify if local or international staff) :
Number of volunteers (Please specify if local or international staff) :
Budget in Afghanistan
Activities in Afghanistan
Activities / Project(s) implemented(s) or ongoing projects in Afghanistan (title, work field, location, budget, period (Year,
duration), technical partners and/or financial partners, summary of activities):
Funds already received from French Ministry of Foreign Affairs or French
Development Agency (AFD)
-
Project title :
Working field :
Location :
Total cost of the project:
Amount of funds:
Period (Year, duration):
Summary of activities:
1
Project title
Country: Afghanistan
Project location:
Project duration:
Targeted population:
Main goal:
Specific goals:
Activities:
Total cost of the project $:
Amount of the requested fund from ICSSCP $:
Contribution of the beneficiary organization:
Operator status (If other than the applicant)
Legal status
Date of foundation
Working field
First name and last name of the focal point
Summary of the project (half page maximum)
This summary will help us understand the challenges, goals and the actions considered
Context of the project (Two pages maximum)
Please describe the situation on the field before the start of the project
Project goals (Two pages maximum)
Please describe the main goal and the specifics goals of the project
Expected results
Indicators showing project’s follow-up
2
Activities (Two pages maximum)
Please describe the actions to take to achieve the goals.
Activities calendar
Please provide the forecast calendar of the activities
Extension possibilities (Two pages maximum)
Please describe the duplication or extension possibilities of the results obtained by the project
Methods for sustainable results (Two pages maximum)
Veuillez décrire les possibilités d’autofinancement du projet à l'issue de l'aide, et le cas échéant, l’organisation de
l’entretien des ouvrages, le financement des travaux d’entretien, etc. .
Please describe the possibilities for self-funding after the ICSSCP, regarding for example the organization,
maintenance of building, etc.
Methods for the beneficiaries to manage the project
Please describe the beneficiaries’ involvement in the process, their responsibilities, their selection procedure etc.
Participation and involvement of the local authorities
Budget
Unit
price
Equipment
Property investment (land, premises…)
Securities investment
Technical installations, equipment, tools
Purchase of rent of vehicles
Securities and IT equipments
Spare parts for machineries
Other (please specify)
Functioning
Cost of the vehicles
Housing rents and other charges (water, electricity, gas)
Office supplies
Management costs
Communication
Other services (maintenance, telephone/fax…)
Other (please specify)
Human resources
Salaries (technical staff, administrative staff and support)
Per-diem for the missions/ travels/ participation in
seminars or conferences
Reports and external expertise
Analyses
Technical assistance
Trainings
Support, follow-up, control
Seminars and conferences’ cost
Other (please specify)
Other expenses
Administrative and management expenses
Total cost of the project, division of funding between
the partners
3
$
Quantity Total
Beneficiary
$
%
SDF
$
%
Resources (% calculated on the total expected budget)
Amount
$
Own funds
Partners
Donators
…..
Total amount of the resources
Requested amount from ICSSCP
Grand total
4
%
Type of
commitment
(indicate if
achieved of
requested)
DOCUMENTS TO BE PROVIDED
List of the documents required to complete your funding demand file under Innovative for civil
society and stakeholder coalition projects program framework.
Thank you for making a cross sign in front of the numbers below when the related document is
provided.
Number
Attached
document
Required documents
1
The application form of funding, filled carefully as per the canvas
attached (please follow the writing indications).
2
A map showing the exact location of the project.
3
The official declaration and statutes of the beneficiary
organization.
4
All other documents that the applicant consider useful for him to
support his application, especially photos.
5