Annex 1

Grant Application Form

Call for proposals under bilateral relations fundof Programme RO14

Applicant
Registration no. / Programme Operator - Bilateral Relations Fund Call
Registration no.
Title of the support project
Name of applicant organization
Type of organization (mark with x,as appropriate) / Research organization that qualify for public institution / Research organization
Fiscal Code
VAT Status
Address (street, street no., zip code, city, country)
Applicant website
Name of project leader
E-mail address
Telephone number
Short description of applicant’s organization / Briefly describe the organization involved in this project:
-Object of activity/field of research
-Organizational profile
-Portfolio of projects
Type of instrument applied for (mark with x, multiple choice is possible) / Instrument / Host country
B1 Participation to events/meetings/visits/training/courses
B2Organization of events/meetings/visits/training/courses
Objective/s of the application(max. 20 lines) / Please describe the main objective and other secondary objectives that you wish to fulfil as a result of the implementation of the project.
Context of the application(max. 10 lines) / Describe the relevance of the project from the point of view of the objective of Programme RO14.
Description and justification of the application and of the planned activities(max.110 lines) / Describe and justify the project proposal, present the participants to the activities and the place of the activities.
Describe the project activities related to the strengthening of the bilateral cooperation. How will the outcome of the individual activities contribute to strengthening of the bilateral relations?
For instrument B1, present as an enclosure the invitation from the organizer of the event/meeting/visit/training/course, including the schedule/agenda of the meeting/correspondence related to this topic (if applicable). For instrument B2, present as an enclosure the invitation sent to participants and the list of participants invited to attend the event/meeting/visit/training/course.
For instrument B2, please describe the actions that will promote the event and the information on the activities and their outcome, including the involvement of the media, if this is the case.Provide details on how you are going to ensure the visibility of the event/meeting/visit/training/course and the added value of the actions to promote the visibility of the EEA Grants 2009 - 2014.
In addition, a letter of collaboration giving evidence of the bilateral character of the projectproposal shall be provided.
Results of the application / Please describe the expected outputs of the project proposal and identify the appropriate indicator(s) for each output, according to the attached list of indicators.
Sustainability of the application (max. 20 lines) / Please describe the manner how the continuity of the project will be ensured after the termination of the grant and how you are going to obtain a multiplication effect and a sustainable impact. Please describe how the outcomes of the project will be used after its completion, how they will be copied and distributed and the manner how other relevant stakeholders will benefit from them, describe the role of the partners, if applicable.
Indicator(s) / Estimated value / Detail of the indicator
Name of theindicator[1] / Provide an estimated numerical value of the indicator(s)to be achieved as a result of implementing the project proposal. / Accurately describe the indicator(s) of the proposed activities. If needed, add further explanations.
Implementation period / Starting date: / Completion date:
Type of instrument / Category of expenditure / Number of units / Value of the unit in euro / Total in euro less VAT (this column shall be filled in only by VAT payers) / Total in euro, VAT included
B1 Participation to events/meetings/visits/training/courses
AND/OR
B2Organization of events/meetings/visits/training/courses
TOTAL[2]
REQUESTED GRANT:
Justification of the budget (max. 40 lines) / Provide details for each type of expenditure included in the budget, by indicating how it came to the amounts referred to in the above table.

Signatures

I certify that I am duly authorized to sign this application form and that the information provided is accurate.

I confirm that planned bilateral activities will be conducted as described in this application and that the proposed expenditures are correct estimated.

I agree that the data contained in this application form and in the attached forms and documents to be used in accordance with Law no. 677/2001 on the protection of individuals with regard to the processing of personal data and on the free movement of such data, with subsequent amendments.

Applicant:

Date: [dd-mm-yyyy]
Place: / Name of the Legal Representative (please use capitals)
Position of the Legal Representative
Signature of the Legal Representative
Organization stamp

Attachement List of indicators

INDICATORS

The applicant may choose one or more of the standard indicators suggested below, or identify any other indicator considered to be more relevant to the project proposal in question.

The quantitative indicators aim at reflecting the level of the expected outcome:

  1. cooperation between the donor states and the beneficiary state
  2. common outcome (objectives)
  3. extent of the impact
  4. mutual knowledge and understanding

Quantitative indicators

Type 1 results: Extent of cooperation

Number of participants involved in visits for sharing experience between the beneficiary state and the donor states

Number of participants from the public sector

Number of participants from the private sector

Number of women/men involved in exchange visits between beneficiary and donor states

Type 2 results: Shared results

Number of new adapted policies, laws and regulations, as a result of bilateral cooperation

Number of joint (bilateral) articles published, written by persons from both an institutions in a beneficiary and donor state, published in national or international publications, originated from a project financed by the programme

Number of joint (bilateral) scientific papers written with co-researchers in at least one beneficiary and one donor state, and published in a national or international scientific publication, originated from a project financed by the programme

Number of new technologies/practices, including IT systems, implemented in the beneficiary state, as a result of the transfer of know-how from the partners in the donor state

Number of new technologies/new practices, including IT-systems, adopted in a donor state, as a result of transfer of knowledge from beneficiary state partners

Type 3 results: Knowledge and mutual understanding

Number of articles published in one country about the other partner country

Type 4 results: Wider effects

Number of common initiatives, in a beneficiary state or in a donor state (joint project applications envisaged)

Number of professional networks between institutions in beneficiary and donor states established and operational

Number of European and international networks where project partners participate together

Number of joint, sector-wide initiatives, in a beneficiary or donor state, beyond the project

Number of joint initiatives in the European or international arena or multilateral organisations

Number of cooperation activities or initiatives in international fora between senior decision makers / politicians, as a result of joint projects

Qualitative indicators:

In addition to the above quantitative indicators, some suggestions for qualitative indicators are given. Data can be gathered through surveys, interviews, focus group discussion, etc. If reliable data cannot be found, please give a qualitative assessment of the results.

Example of possible qualitative indicators:

Level of satisfaction of the participants / final beneficiary (perceived as stimulating / enriching / enabling)

Improved benefits

Expanded capacity

Access to valuable professional or technical skills

Access to valuable administrative and organisational skills

Increased access to participation in regional and international networks

More international exposure and participation

Level of knowledge about the other institution (structure, work programme, policies, etc.)

Knowledge about the EEA Grants

Understanding of the other country’s cultural, political and socio-economic situation

Awareness in the donor and beneficiary states of the donor states contribution to solving European challenges in the beneficiary state.

1

[1] Please see the attachment with the list of indicators.

[2] According to the VAT status of the applicant, the corresponding column shall be filled in.