MENA Common Ground Institute Small Grants Call for Proposals: Tunisian and Egyptian Civil Society Scheme

Application Form

About the Applicant:

Name of organization:
Head of organization (title):
E-mail:
Telephone:
Contactperson:
Position:
E-mail:
Telephone:
Address:
Country:
Website:
Facebookpage:
Year of establishment:
Type of organization:
Legal registration date and number:
Mission and objectives(maximum 300 words):
Experience in similar projects (maximum 300 words):

About the Project:

Title:
Starting date:
Ending date:
Location:
Project coordinator(s):
E-mail:
Telephone:
Partner(s)if any:

Context and need(maximum 500 words):

Please describe the background/context/rationale behind developing this project. Clearly explain how this proposal meets the objectives of the MENA CGI Small Grants Call for Proposals.

Summary(maximum 500 words):

Please give a summary of the project activities, specific objectives, expected results, outputs, participants’ profile, partners, and the impact your project seeks to achieve.

Objectives (bullet-points):

Please list the overall objective(s) and the specific objective(s) in bullet-points.

Overall Objective:
Specific Objective 1:
Specific Objective 2:

Approach(maximum 200 words):

Please describe your methodology and approach for the implementation of this project. Please clearly indicate how dialogue mechanisms are integrated within this project.

Activities(maximum 500 words):

Please describe in details the activities you are planning to organize in order to meet the above-mentioned objectives. This includes information about the preparation, implementation and follow-up of the project activities. Please highlight the role of your organization and partners (if any).

Activities under Specific Objective 1

Activity 1:
Activity 2:
Activity 3:

Activities under Specific Objective 2

Activity 4:
Activity 5:
Activity 6:

Expected results(bullet-points):

Please list the results you want to achieve from each activity in the project including any specific outputs as well. Results should be in line with the specified objectives.

Expected result for activity 1:
Expected result for activity 2:
Expected result for activity 3:
Expected result for activity 4:
Expected result for activity 5:
Expected result for activity 6:

Target group(s):

Please mention the target groups addressed in this project including the direct and indirect beneficiaries and the reasons for choosing specific target group(s).

Project management (maximum 100 words):

Please define how many persons from your organizations and your partner (if any) will work on the project. What are their tasks and responsibilities?

Risks(maximum 200 words):

Please identify the potential risks during the preparation, implementation and follow-up of the project and how you plan to address each risk.

Risks (for each one, please specify low, medium or high risk) / Mitigation strategy
Risk 1 -
Risk 2 -
Risk 3 -

Impact(maximum 200 words):

Please describe the project impact you want to achieveincluding any foreseen sustainability mechanism.

Evaluation(maximum 100 words):

Please define the evaluation plan and tools for measuring the impact of the project activities and results.

Work plan:

Please mark in (x) to indicate when the activities will take place. This includes preparation, implementation of actual activities, evaluation and follow-up. You can add as many activities as you want.

June / July / August
W1 / W2 / W3 / W4 / W1 / W2 / W3 / W4 / W1 / W2 / W3 / W4
Preparation:
Activity 1:
Activity 2:
Activity 3:
Activity 4:
Evaluation:
Follow-up: