The Rotary Foundation (TRF)
Global Grant Scoping Document
Rotary District 9710
Please complete all sections of this application. Rotarians may use this form and attach additional pages as needed. Incomplete applications will not be considered.
Submit this completed Scoping Document form to the Chairman District 9710 Grants Subcommittee by email PDG Phil Armstrong,
See ‘GRANT MANAGEMENT MANUAL for Rotary Clubs which at www.rotary.org for download or from RI Parramatta
REMEMBER: The following pages reflect the online application that must be completed and time taken to complete these details and discussion with the D9710 Foundation Sub Committee Members will be of value and ensure smooth passage of your application
Table of Contents
OBJECTIVES 2
COMMUNITY NEEDS 3
AREAS OF FOCUS 4
PEACE AND CONFLICT RESOLUTION 5
DISEASE PREVENTION AND TREATMENT 6
WATER and SANITATION 7
MATERNAL and CHILD HEALTH 9
BASIC EDUCATION and LITERACY 10
ECONOMIC and COMMUNITY DEVELOPMENT 11
PRIMARY CONTACTS, COMMITTEE MEMBERS, 12
COOPERATING ORGANISATIONS, PARTNERS 12
COOPERATING ORGANISATIONS 12
VOLUNTEERS, ROTARIAN PARTICIPATION 13
SUSTAINABILITY 14
BUDGET 15
BUDGET 2 16
FINANCING 17
LIST OF RESOURCES 18
OBJECTIVES
WELCOME TO THE GLOBAL GRANT APPLICATION
PLANNED ACTIVITIES
In a few short sentences tell us the objectives for this global grant
WHICH OF THE FOLLOWING ACTIVITIES WILL THIS GLOBAL GRANT FUND?
Humanitarian Project
Where will your project take place?
When do you anticipate your project will take place?
FROM UNTIL
Outline your project implementation schedule
# / Activity / DurationSUSTAINABILITY
What community needs will your project address and how were these needs identified?Provide any relevant data or survey results)
Detail how your project will address these community needs.
How were members of the local community involved in planning the Project? Does the Project align with any current or ongoing local intitiatives?
Describe any training, community outreach, or educational programs, if applicable, and
who will conduct them.
How will recipients be selected?
AREAS OF FOCUS
Global grants must support the goals of at least one of Rotary's areas of focus.Select the applicable area(s) of focus and goal(s) that your activity will support:
Peace and conflict prevention/resolution
Disease prevention and treatment
Water and sanitation
Maternal and child health
Basic education and literacy
Economic and community development
The areas of focus selected above will result in a number of questions that depend on the area(s) of focus selected
Please complete the following applicable sheets
In the sections below there will be either free text options or drop down boxes as shown in each section
(Either delete any page that does not apply OR leave blank)
PEACE AND CONFLICT RESOLUTION
Which goals will your activity support?
(place an x next to applicable measure(s)
Training leaders, including potential youth leaders, to prevent and mediate conflict
Supporting peace-building in communities and regions affected by conflict
Supporting studies for career-minded professionals related to peace and conflict prevention/resolution
How will you measure your impact?
Note that global grant sponsors of approved applications will be expected to account for the total number of direct beneficiaries in the final report.
# / MEASURE / METHOD / SCHEDULE / TARGET(please use selections below)
Measure Number of1 / groups and organisations participating in peace-building efforts
2 / Individuals trained
3 / Conflicts mediated
4 / Communities reporting reduction in level of conflict
5 / other
DISEASE PREVENTION AND TREATMENT
Which goals will your activity support?
(place an x next to applicable measure(s)
Improving the capacity of local health care professionals
Promoting disease prevention programs, with the goal of limiting the spread of communicable diseases and reducing the incidences of and complications from non-communicable diseases
Enhancing the health infrastructure of local communities
Educating and mobilizing communities to help prevent the spread of major diseases
Educating and mobilizing communities to help prevent the spread of major diseases
Preventing physical disability resulting from disease or injury
Supporting studies for career-minded professionals related to disease prevention and treatment
How will you meet these goals?
How will you measure your impact?
Note that global grant sponsors will be expected to account for the total number of direct beneficiaries in the final report.
# / MEASURE CUT AND PASTE MEASURE from list below / METHOD / SCHEDULE / TARGETMeasure Number of
1 / Medical and health professionals trained
2 / Individuals reporting better quality of health care services
3 / Communities reporting decrease in cases of disease(s) targeted
4 / Health facilities benefiting
5 / Communities reporting an increase in access to local health facilities
6 / Health-focused events
7 / Health education campaigns
8 / Other
WATER and SANITATION
Which goals will your activity support?
(place an x next to applicable measure(s)
Providing equitable community access to safe water, improved sanitation and hygieneStrengthening the ability of communities to develop, fund and maintain sustainable water and sanitation systems
Supporting programs that enhance communities’ awareness of the benefits of safe water, sanitation and hygiene
Supporting studies for career-minded professionals related to water and sanitation
How will you meet these goals?
How will you measure your impact?
Note that global grant sponsors will be expected to account for the total number of direct beneficiaries in the final report.
# / MEASURE CUT AND PASTE MEASURE from list below / METHOD / SCHEDULE / TARGETMeasure Number of
1 / … People with access to improved sources of drinking water
2 / … People with access to improved sanitation facilities
3 / … People with access to disinfected water through household water treatment
4 / … Communities with a functioning governance committee in place
5 / … Communities utilizing and tariff/usage fee structure
6 / Individuals trained
7 / Other
MATERNAL and CHILD HEALTH
Which goals will your activity support?
(place an x next to applicable measure(s)
Reducing the mortality and morbidity rate for children under the age of five
Reducing the maternal mortality and morbidity rate
Improving access to essential medical services, trained community health leaders and health care providers for mothers and their children
How will you meet these goals?
How will you measure your impact?
Note that global grant sponsors will be expected to account for the total number of direct beneficiaries in the final report.
# / MEASURE CUT AND PASTE MEASURE from list below / METHOD / SCHEDULE / TARGETMeasure Number of
1 / ….Children under the age of 5 receiving medical treatment
2 / … Mothers receiving prenatal care
3 / … Maternal and child health professionals trained
4 / … Communities that report decreased mortality rates of children under age 5
5 / … Communities that report decreased morbidity rates of children under age 5
6 / Communities that report decreased mortality rates of mothers
7 / Communities that report decreased morbidity rates of mothers
Benefiting health facilities
Other
BASIC EDUCATION and LITERACY
Which goals will your activity support?
(place an x next to applicable measure(s)
Involving the community to support programs that strengthen the capacity of communities to provide basic education and literacy to all
Increasing adult literacy in communities
Working to reduce gender disparity in education
Supporting studies for career-minded professionals related to basic education and literacy
How will you meet these goals?
How will you measure your impact?
Note that global grant sponsors will be expected to account for the total number of direct beneficiaries in the final report.
# / MEASURE CUT AND PASTE MEASURE from list below / METHOD / SCHEDULE / TARGETMeasure Number of
1 / ….Benefiting school age children
2 / … New school-age children
3 / … New female school-age children
4 / … Teachers receiving training in adult education
5 / … Institutions participating in program
6 / Adults using new literacy skills
7 / New teacher positions created
8 / Other
ECONOMIC and COMMUNITY DEVELOPMENT
Which goals will your activity support?
(place an x next to applicable measure(s)
Building the capacity of entrepreneurs, community leaders, local organizations, and community networks to support economic development in impoverished communities
Developing opportunities for productive work
Reducing poverty in underserved communities
Supporting studies for career-minded professionals related to economic and community development
How will you meet these goals?
How will you measure your impact?
Note that global grant sponsors will be expected to account for the total number of direct beneficiaries in the final report.
# / MEASURE CUT AND PASTE MEASURE from list below / METHOD / SCHEDULE / TARGETMeasure Number of
1 / ….Entrepreneurs supported
2 / … Business supported
3 / … Individuals trained
4 / … jobs created
5 / … Youth employed in income-generating activities
8 / Other
PRIMARY CONTACTS, COMMITTEE MEMBERS,
COOPERATING ORGANISATIONS, PARTNERSThe global grant committee should consist of six Rotarians:
Ahost committeeof three Rotarians from the country where the project will take place and
Aninternational committeeof three Rotarians from a different country
Add the members of the global grant committee so that they all can view this application. These individuals will receive an email notification that they have been added as committee members for this grant.
Rotarians who do not have a valid email address listed in Rotary’s membership records will not appear in search results. You can search for Rotarian committee members by name, Rotary Member ID, or club.
PRIMARY CONTACTS
International (Australian RC)
Name
Club
Sponsored by Club
Host (overseas RC)
Name
Club
Sponsored by Club
COMMITTEE MEMBERS
Host
Name1
Name2
International
Name1
Name2
COOPERATING ORGANISATIONS
Cooperating organisations are reputable non-Rotary organizations or academic institutions that provide expertise, infrastructure, advocacy, training, education, or other support for the grant.
Identify any cooperating organization participating in your project.
Name Website Address City Country
MOU between Sponsors and Organisation
Upload the memorandum of understanding (MOU) between the primary sponsors and the cooperating organization in PDF format.
PARTNERS
List any additional partners who will participate and identify their responsibilities. This may include Rotary clubs, Rotaract clubs, Rotary Community Corps, or individuals
.
VOLUNTEERS, ROTARIAN PARTICIPATION
Volunteer Traveller(s)
International travel for volunteers is permitted for up to two individuals as part of a humanitarian project. These individuals provide training or implement the project should the host sponsor confirm that their skills are not readily available locally.Identify any Rotarian or non-Rotarian whose international travel will be funded by this global grant.
(see below)
Name Email
Files required(pdf)
Curriculum vitae, Daily Itinerary (including travel, training and/or project implementation activities
CONFIRMATION BY HOST CLUB
I confirm that the host club or district has extended a travel invitation, fully supports
and approves volunteer traveler(s), and verifies that the international travel to the club and/or district
is needed to implement the project.
ROTARIAN PARTICIPATION
Describe the role of the host Rotarians in this activity and list their specific responsibilities.
Describe the role of the international Rotarians in this activity and list their specific responsibilities.
SUSTAINABILITY
Describe the role that members of the local community will play in implementing your project.
What incentives (e.g., compensation, awards, certification, promotion) will you provide
to encourage local participation?
Identify any individuals in the local community who will be responsible for monitoring outcomes and ensuring continuity of services. How will you support these individuals to help them take on this leadership role?
BUDGET
/ CATEGORIESSelect the local currency for your budget and enter the current rate of exchange
Obtain the current RI exchange rate from the Rotary website.
Detail your proposed expenses by adding items to the budget.
Note that the total budget must be equal to the total financing of your activity.
Documents required to be uploaded include price bids, proforma invoices
to support expense list
Exchange Rate / $AUS 1 = / $ 1.06
No. / Description / Supplier / Category / $AUD / $USD
(Note complete AUD amounts only. The $US amount will automatically be calculated on the web version)
BUDGET 2
SUSTAINABILITY
Describe the process for selecting these budget items. Do you plan to purchase any items from local vendors?
Have you performed a competitive bidding process to select vendors?
Do these budget items align with the local culture and technology standards?
How will the beneficiaries maintain these items? If applicable, confirm that spare or replacement parts
are readily available and that the beneficiaries possess the skills to operate equipment.
Who will own the items purchased with grant funds at the end of the project, including equipment, assets,
and materials? Note that items cannot be owned by a Rotary club or Rotarian.
FINANCING
The Rotary Foundation funds global grants from the World Fund, and awards range from US$15,000 to US$200,000. The Foundation matches cash contributions at 50 percent and District Designated Fund (DDF) contributions at 100 percent. The Foundation will also match non-Rotarian contributions toward a grant, provided they do not come from a cooperating organization or a beneficiary.
To determine the World Fund match for your global grant, list all sources of funding, specifying contributions from cash, DDF, and other sources. Note that the total financing must be equal to the total budget of your activity.
(This area should be completed after District Approval and in consultation with the Foundation Committee
Funding Method
i.e. DDF, Cash from District, Cash from Club, Other, Endowed/Term Gift
$USD
CASH FROM CLUB
CASH FROM DISTRICT
DDF
OTHER
ENDOWED /TERM GIFT
LIST OF RESOURCES
Areas of Focus Statement of Purpose and Goalshttp://www.rotary.org/document/595
Monitoring and Evaluation Supplement
http://www.rotary.org/document/667
Grant Terms and Conditions
http://www.rotary.org/myrotary/en/document/728
Grant Management Manual
http://www.rotary.org/document/673
Coperation Organization MOU
http://www.rotary.org/document/633
Intinerary
http://www.rotary.org/document/774
RI Exchange Rates
http://www.rotary.org/node/12891