2010 Avon Award for the Elimination of Gender Based Violence

APPLICATION FORM

2010 Avon Award for the Elimination of Gender Based Violence

Public Affairs Section

U.S. Embassy Beijing

Due:Thursday, September 30 by 23:59 p.m.

All applications must be submitted to and . If you have any questions prior to submission, contact Hu Hejuan at (010) 8531-3046 or

Applications Must Be Submitted in English

Proposals must support program activities that address key gender-based violence problems in China. Priority will be given to new projects or programs.

Grants may be made to non-governmental, not-for-profit organizations based in China that demonstrate long-term sustainability beyond the proposed program activity. Individuals are not eligible. Third-country individuals and organizations are not eligible.Chinese individuals are only eligible if they are affiliated with an organization that can provide long-term sustainability for the program activity.Proposals may be for up to U.S. $50,000.Grants will be made for one to two year projects.

Short-term salaries and other minor administrative expenses directly linked to implementation of the program are eligible for funding.Grant funds may be used to train trainers, seminars and workshops, but the proposals must describe the expected audience, content, and timeframe and justify the activity in terms of outcome and benefits to U.S. national interests.Grant funds may be used for the publication of materials, but the proposals must describe the audience, content and means of distribution. Grant funds may be used for food or refreshments up to 10% of the budget and where associated with the project. Grant funds may not be used for alcohol or entertainment.

Grantees will be required to submit quarterly interim and one final project and budget report in English.

Embassy/Consulate (Beijing, Shanghai, Guangzhou, Chengdu, Shenyang or Wuhan):

Embassy/Consulate Point of Contact:

Name of the project:

Amount requested (in US $):

* Maximum amount is $50,000

Name of the organization (in English and Chinese):

Address (in English and Chinese):

Phone and fax numbers; e-mail address; web site address:

Project Coordinator (name, title):

Brief background of the organization, project coordinator and key people:

Previous funding (include all current and completed donor funded projects in the last three years including the name and contact information for each donor):

Project statement (background of the program supported by qualitative and quantitative information such as recent research or statistical data as well as existing efforts in the country):

Project goals, objectives, and performance indicators (the goals and objectives of the project should be logically linked to eliminating gender based violence and applicants should specify quantifiable output and outcome performance indicators for each objective.):

Implementation and Sustainability (implementation plan including a time line for completion of the project activities as well as an outline of how the project might be expanded or scaled in the future):

Project dates (project length can be one to two years):

Project Justification (up to one page). Project Justification will be submitted by Embassy/Consulate official.

Detailed budget(use separate sheet if needed):breakdown or spreadsheet showing costs in each of the budget categories listed below, showing quantities, unit costs, and other similar details.

Personnel - For each staff person, provideinformation such as job title, time commitment to the project as a percentage of full-time equivalent, annual salary (or wage rate), and salary from grant funds.

Fringe Benefits - Provide a breakdown of the amounts and percentages that comprise fringe benefit costs for employees, including required local taxes and insurance. Fringe benefit costs should be shown separately from salary costs and include an explanation of how benefits are computed for each category of employee.

Travel - Identify staff and participant travel and per diem allowance calculations. Per diem rates may not exceed the published USG allowance rates, but applicants do have the option of using lower per diem rates.

Equipment - For each type of equipment requested, providea description of the equipment, the cost per unit, the number of units, and the total cost.

Supplies - List items separately using unit costs for photocopying, postage, telephone/fax, printing, and office supplies.

Contractual - Provide the costs of all contracts for services and goods, except for those that belong under other categories (such as equipment, supplies, etc.). If consultants will be used in the grant, provide all costs related to their activities, including travel and per diem costs.

Other Direct Costs - Provide computations for all other costs directly associated with this project. These costs, where applicable and appropriate, may include but are not limited to professional services, space and equipment rentals, stipends, telephone and electricity.

* Refer to “REQUEST FOR APPLICATIONS TO THEAVON AWARD FOR THE ELIMINATION OF GENDER BASED VIOLENCE”, page 3,for a detailed list of non-allowable costs.

Who will prepare the interim and final program and financial reports? (Please note that all program and financial reports MUST be submitted in English)

Other sources of support for this project (including from the applicant organization):

______

City, dateSignature of Applicant (typed name is fine for electronic application)