Sotsiaalkaitseministri 10.02.2015 käskkirjaga nr 21 kinnitatud
Norra finantsmehhanismist 2009-2014 rahastatud programmi
„Sooline võrdõiguslikkus ning töö- ja pereelu tasakaal“
kahepoolsete suhetefondist toetuse andmise tingimuste
juhendi lisa 1
ANNEX 1: APPLICATION FORM
for Applying for Support from the Fund for Bilateral Relations
“Mainstreaming Gender Equality and Promoting Work-Life Balance”
Norwegian Financial Mechanism 2009-2014
GENERAL INFORMATIONThe given form will be used in the evaluation of initiatives submitted in the framework of the open call in the Fund for Bilateral Relations. The aim of the fund is to facilitate and support cooperation between entities from Estonia and Norway as well as international organisations.
We ask that you carefully read the guidelines for applying for funding from the call for proposals and the criteria for evaluating applications before submitting the application. We also strongly encourage reading the Regulation on the implementation of the Norwegian Financial Mechanism 2009-2014 as well as the Guidelines for strengthened bilateral relations publishedby the Financial Mechanism Office[1].
The application must be filled out in English and submitted to the Ministry of Social Affairs ofEstonia (together with all the relevant annexes) by 30 September 2015 and at least 30 workdays before the activities are expected to begin.
All entities that have previously received funding from theProgramme’ssmall grant schemeare considered as eligible applicants.
Activities that have already been planned (i.e. have been budgeted for) in the projects funded from the small grant scheme will not be supported. The applicant is responsible for mitigating any risks related to double financing.
- SUBMISSION DATA
Submission Format / ☐ Electronic
☐Paper carrier
Title of the Initiative
in English / Click here to enter text. /
Title of the Initiative
in Estonian / Click here to enter text. /
- APPLICANT AND OTHER COUNTERPARTS
B.1 Applicant organisation
Name of organisation / Click here to enter text. /
Legal status / Click here to enter text. /
Registration number / Click here to enter text. /
Address / Click here to enter text. /
Zip-code / Click here to enter text. /
City/town / Click here to enter text. /
Country / Estonia
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
Homepage / Click here to enter text. /
B.1.1 Person Authorized to Sign the Grant Agreement
First name / Click here to enter text. /
Last name / Click here to enter text. /
Position / Click here to enter text. /
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
B.1.2 Contact Person
☐ / Check here if same as C.1.1 – Person Authorized to Sign the Grant Agreement and continue without adding contact information below
First name / Click here to enter text. /
Last name / Click here to enter text. /
Position / Click here to enter text. /
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
I allow the Ministry of Social Affairs to send information and documents to the e-mail address noted above / ☐ YES / ☐ NO
B.2 Project Partners in the Small Grant Scheme(Please list the organisations that you have partnered with in the small grant scheme and indicate who are participating in the initiative by checking the box at the end of the row).
Check here if there were no Project Partners in the Small Grant Scheme and continue with section B.3 – Foreign Organisations / ☐
Full Legal Name in Estonian / Full Legal Name in English / Participation
in the initiative
1 / Click here to enter text. / Click here to enter text. / ☐
2 / Click here to enter text. / Click here to enter text. / ☐
3 / Click here to enter text. / Click here to enter text. / ☐
4 / Click here to enter text. / Click here to enter text. / ☐
5 / Click here to enter text. / Click here to enter text. / ☐
B.3 Foreign Organisations (i.e. Norwegian or International Organisations) involved with the Initiative.
Name of organisation / Click here to enter text. /
Legal status / Click here to enter text. /
Registration number / Click here to enter text. /
Address / Click here to enter text. /
Zip-code / Click here to enter text. /
City/town / Click here to enter text. /
Country / Click here to enter text. /
Phone / Click here to enter text. /
Homepage / Click here to enter text. /
B.3.1 Contact Person
First name / Click here to enter text. /
Last name / Click here to enter text. /
Position / Click here to enter text. /
Phone / Click here to enter text. /
E-mail / Click here to enter text. /
B.3.3 Background and Expertise. Please describe thecooperating organisation’sprior experience in the field of gender equality and/or work-life balance and why you have chosen to cooperate with them. Include a brief summary of the nature of your planned cooperation.
Click here to enter text. /
If there are other foreign organisations involved with the initiative that you are collaborating with or that contribute actively to achieving the initiative’s outcomes, then please provide their information below as exemplified in section B.3.
[Copy information on additional organisations here]
C. Duration of the Initiative(in weeks or months) / Click here to enter text.
Start Date[2] / Click here to enter text.
End Date[3] / Click here to enter text.
D. Please describe the initiative and your motivation behind it.How will the initiative contribute topromoting bilateral relations (i.e. improved knowledge and understanding) between the cooperating organisations)?
Click here to enter text.
E. Please describe the shared results that will be achieved(i.e. how will both cooperating organisations benefit from the initiative).What particular knowledge, experience, know-how and/or technology will be shared to achieve the expected results?
Click here to enter text.
F.How will the initiative contribute to the programme’s objectives of promoting gender equality and/or work-life balance?How will the initiative complement the project that is already in implementation (i.e. the project funded from the small grant scheme)?
Click here to enter text.
G. What are some of the wider effects[4] that could be expected as a result of the organisations working together and finding common ground to extend their cooperation?
Click here to enter text.
H. Description of the target group(s).Please provide a brief description of the main target group(s) as well as any potential indirect beneficiaries of the initiative.
Click here to enter text.
I. Measuring the success of the initiative. Please provide a brief description of the qualitative and/or quantitative indicatorsthat you plan on using to measure the success of the initiative.
Click here to enter text.
J.Chronological agenda. Please provide an agenda and schedule of the main activities as exemplified in table 1. Modify the table as needed
Activity / Duration / Guarantor
(person-based) / Target Group
(if applicable)
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text.
K.Visibility. If the initiative is directed to a wider audience, then please describe how you plan on making it visible to the target group(s) as well as society at large (posters, blogs, informational meetings, other media, etc.).
Click here to enter text.
L. Risk Analysis. Please analyse the potential risks that may come up during the execution of the initiative.
Description / Measures for prevention and elimination
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
M.Budget. Only those expenses that have been made during the period when the expenditures are eligible can be considered part of the overall budget. For more information on eligibility, see XXX of the Guidelines.
Expense category / Unit of measurement (hour/person/etc.) / Unit Price / Total
- ...
- ...
- ...
- (insert additional rows as needed)
€
Total cost of the initiative / Click here to enter text.
- Letters of Understanding
To be completed by the person authorised to enter into legally binding commitments on behalf of the applicant
The applicant undertakes to inform theProgramme Coordinator at the Ministry of Social Affairs of Estonia of all changes affecting the activities as described in this form.
The applicant allows the Department of Equality Policies at the Ministry of Social Affairs of Estonia to use all the data provided in this application form for the purposes of managing and evaluating the initiative submitted under the call for proposals “Advancing Bilateral Relations”.
In the event that this application is successful, the Ministry of Social Affairs of Estonia has the right to publish (online or in any other appropriate medium):
- the name of the beneficiary of the grant (and relevant counterparts);
- the amount awarded;
- information on the content of the initiative.
All personal data collected for the purpose of this initiative shall be handled in accordance with the Estonian Personal Data Application Act[5]. If at any time, the person submitting the data thinks that his/her personal information has not been handled properly, he/she has the right to turn to the Data Protection Inspectorate.
Full legal name / Click here to enter text.
Position / Click here to enter text.
Signature / Click here to enter text.
Date / Click here to enter text.
To be completed by the person authorised to enter into legally binding commitments on behalf of the applicant
I, the undersigned, hereby request a grant from the Norwegian Financial Mechanism 2009-2014 programme “Mainstreaming Gender Equality and Promoting Work-Life Balance” in the amount ofClick here to enter amount EUR to implement the action described in the application at hand.
I certify that all information contained in this application, including the description of theinitiative, is correct to the best of my knowledge and I am aware of the content of the annexes to the application form.
I certify that the applicant organisation has the financial and managerial capability to execute the proposed initiative successfully.
I certify that the applicant organisation is not in any of the following situations:
- bankrupt or being wound up, their affairs are administered by the courts, have entered into an arrangement involving creditors, have suspended business activities, are the subject of proceedings concerning those matters, or are in any analogous situation arising from a similar procedure provided for in national legislation or regulations;
- has been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata;
- has been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation, money laundering or any other illegal activity;
- has been in serious breach of contract or has failed to comply with following another procurement procedure or grant award procedure;
- not in compliance with their obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the Estonian Republic.
- are not in a situation where there is a conflict of interests[6];
- have not presented false information;
- have not applied for any funding for the same initiative from other grant programs, EU programs, or from the Estonian state budget.
Full legal name / Click here to enter text.
Position / Click here to enter text.
Signature / Click here to enter text.
Date / Click here to enter text.
CHECKLIST
Before submitting your application to the Ministry of Social Affairs of Estonia, please verify the following:
☐ / the application is signed (either electronically or on paper);
☐ / the application is submitted on the correct form (Annex 1) and all sections have been completed;
☐ / the grant amount requested is within the maximum and minimum amount as set forward in the guidelines for the call;
☐ / the start and end date of the initiative are within an allowed period;
☐ / the applicant has previously received funding from the small grant scheme in the programme “Mainstreaming Gender Equality and Promoting Work-Life Balance”;
☐ / All relevant CV-s (initiative manager, team members, experts) are attached to the application (or have previously been submitted to the Ministry of Social Affairs of Estonia in the open call of the small grant scheme);
☐ / Commitment letters (Annex 2) are attached to the application (if applicable);
☐ / the applicant has signed the letters of understanding (section N) stating that no liquidation or bankruptcy proceedings have ever been started against them;
☐ / the applicant has no national or social security tax debts (According to the Estonian Tax and Customs Board’s database);
☐ / in the case of the existence of a foreign counterpart, the counterpart is registered as a legal person in Norway. International organisations qualify as project counterparts as well;
☐ / the application meets the deadline (30 September 2015) and is submitted at least 30 workdays before the planned start date of the activities.
We request that the application with all its annexes be sent electronically or delivered by mail to the Ministry of Social Affairs by or on30 September 2015 and not later than 30 days before the activities are planned to begin.
Postal address:
Sotsiaalministeerium
Võrdsuspoliitikateosakond
Gonsiori 29
15027 TALLINN
E-mail:
Depending on how you submit your application, please write either as the subject of the e-mail or on the envelope “EE09 kahepoolsedsuhted”
NB! When submitting the application by mail, do not staple the documents
NB! When submitting the application electronically, keep the document in the form of a Microsoft Office Word document (.doc, .docx, .rtf, etc.)
[1]All of the documents are available on the programme’s website at
[2] The application must be submitted at least 30 workdays before the planned start
[3] Activities must end by 31 March 2016.
[4]“Wider effects might happen as a result of institutions working together and finding common ground for extending their cooperation beyond the projects and programmes. Examples could be common sector-wide initiatives, work to address common European challenges and/or joint initiatives in inter-governmental organisations. The wider effects may represent an important added value and have an impact on bilateral relations. In the area of bilateral cooperation it is important to keep in mind that there is not necessarily a proportional relationship between size of investment and magnitude of results. A small event may have a major catalytic and symbolic effect. In many cases such events and results emerge as spin-offs from joint initiatives, and can have long-lasting effects” (Guidelineforstrengthenedbilateralrelations, publishedbytheFinancialMechanism Office).
[5]
[6]A conflict of interest is a situation in which a relationship between an applicant and an official from the Ministry of Social Affairs and/or an evaluator may lead to a conflict between either party’s professional and private interests in which the private interests of an official or evaluator may influence the impartiality and objectivity and the responsibility related to that.