Crisis Response Fund

Crisis Response Fund

Request Form

As per the guidelines, all requests to use the Fund must ensure this form is completed.

Applicant Information

Name of applying organisation
Name of contact person
Physical and postal address
Telephone
Email
Country in which activities will be implemented
Date of submission
Time period
Maximum 6 months
Budget
Maximum 10,000 USD

Application Details

1. Please give a brief background onthe country context and the work your organisation does:

1. Please give detailed background information on the specific restrictions to freedom of association and/or assemblyin your country and the specific situation youractivitieswill address:

1. Please give examples of the most recent restrictions to freedom of association and/or assembly and outline how it is a crisis:

1. Please describe the activities you intend to implement

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5. Who is the target of the advocacy project activities? This could be legislators, the judiciary, a government agency, regional bodies, general public, the media, or another audience.

6. Please providespecific examples of how your actions will improve the current restrictions to freedom of association and/or assembly situation?

7. What is a measurable indicator that will tell us whether this project has achieved the results noted above? If the project is unable to achieve these results, what are there interim sub-goals that would indicate the project’s success?

8. What existing work is being done by civil society to address civic space restrictions in your country?

9. Have you partnered with CIVICUS in the past? If yes, please provide details of the work. If no, do you know of any other civil society organisations/actors in your country or context who haveworked with CIVICUS?

10. Are you a member of CIVICUS? If yes, are you an associate member or a voting member?

11. What is the total budget for the activities above? And what is requested from the Crisis Response Fund?Funding support from the CRF is capped at 10,000 USD.

12. Have you approached other funders to assist with the cost of your proposal? If yes, please indicate who, how much, and if funding has been secured.

13. Does your organisation have the capacity and resources to implement the above project? Have you implemented similar projects in the past? Please elaborate if necessary.

14. What further support, outside of the Crisis Response Fund grant, would you like from CIVICUS such as international advocacy support, interviews, statements or contact to other relevant CSOs?

15. Please provide contact details (email and phone number) of two references from national or international organisations you work with who CIVICUS can contact to verify your organisation/application.