APPLICATION FORM 2017


Application form: Strand 2 | PtP Multi-Annual Support

Project Name / Working Title
Full Official Name of Organisation
Official Address
Voluntary Organisation Number / Company Registration Number (where applicable)
Name and Surname of Legally Authorised Person
Position in Organisation
ID Card Number
Contact Details
Postal Address of Legally Authorised Person:
Telephone Number: / Mobile Number:
Email:
Name and Surname of Project Manager
Position in Organisation, (where applicable)
ID Card Number
Contact Details
Postal Address of Project Manager:
Telephone Number: / Mobile Number:
Email:
Organisational Profile of Applicant
Organisational Profile of Partner Organisation(s) or Institution(s)
Kindly specify the name(s) and dates of the project(s) held between 2012 and 2016 with the support of public fund.
Project Time Frames
Indicative Start Date: Indicative End Date:
Project Location
Target Social Groups addressed by the project
Main target beneficiaries of the project:
Children □ Youth □ The elderly □ Hard-to-reach groups □
People with different abilities □ People from different ethnic backgrounds □
Addressing:
□ Behavioural, emotional and social difficulties (e.g. having suffered from abuse, facing charges or Juvenile Court proceedings, etc.)
□ Mental health problems / disability / chronic conditions
□ People who support family members with mental health problems / disability / chronic conditions
□ Families with very low income / dependent on social benefits
□ Institutionalised children and young people
□ Special social integration needs
Project Description and Anticipated Outcome
Suggested Maximum: 150 words
Amount Requested from Il-Premju tal-President għall-Kreattività
Maximum amount that can be requested from this Award is €15,000 over the whole duration of the specific grant
You may request up to 80% of the project expenditure

Did you already benefit from other public funds to cover the costs of development of your original project for which you are requesting financial support in this application?
If yes, this project is ineligible for financial support from this Programme.

Yes

No

Evaluation Criterion 1 : Community development and well-being

a) Provide a round-up of the specific community project that was carried out with the previous support of the Award is now being proposed for further development (including relevant documentation, links, and materials)

b) What specific community needs does the project address, and how is the project relevant to the Create2020 Strategy goals targeted through this Award

c) Explain the creative process involved, rationale, goals of the project

d) Explain the project’s contribution towards inspiring and enabling community development

e) Provide a development plan (1st January 2018 to 1st June 2020) for the specific community project the Organisation had successfully completed with the support of Il-Premju tal-President għall-Kreattività in past years, and that is now being proposed for further development

Evaluation Criterion 2: Widening of participation in cultural life

a) Explain the project’s contribution towards widening participation of disadvantaged groups in quality arts experiences, arts-engagement activities, creative exchange

b) Provide a clear outline of the range of artistic experiences that the project proposes

Evaluation Criterion 3: The quality of the project

a) Attach/add links to CVs/bionotes of the proposed project team members and all collaborators

b) Provide a dissemination plan for the project

Evaluation Criterion 4: Project Management

a) Provide a clear project plan

b) Provide project time frames

c) Provide a project budget, explaining efforts to secure funds from other sources

Use Annex 1 as a template for your budget. Add budget items according to your project. All items should be in Euro.

*It is important to provide copies of any relevant quotations that can give an indication of estimated costs. All official quotations and confirmations are to be attached to this application. Whenever quotations cannot be supplied, you can provide a breakdown of estimated costs based on standard expenditure. Other sources of funding and sponsorships must be supported by relevant documentation.

Name and Surname / Date / Signature

By signing this declaration I confirm that, to my knowledge, all the information contained in this application form and its annexes is correct.

By signing this declaration I confirm that I have read the Award Guidelines and Regulations and that I accept the Award’s conditions and process as stipulated in that same document.

The application, which must contain all the required material, must reach the Office of the President by the deadline of Tuesday 25th July 2017 at 12.00pm. You can submit your application form between Monday and Friday from 09:00 till 16:30 by one of the following methods:

By email to:

or

By hand / registered post to:

Arts Council Malta

16, Casa Scaglia

Mikiel Anton Vassalli Street

Valletta VLT 1311

On the day of the deadline, application forms will only be accepted until noon (12:00). Applications that reach the Council after the deadline will not be accepted.

Any queries in connection with the above can be sent by email to: or by phone on 2339 7020.

FOR OFFICE USE ONLY
Date of receipt: Application Number:

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