Concept Note

For a project of :

Sustainable Agriculture

Sustainable Fisheries

Biodiversity Conservation

Sustainable Technologies

(Only keep the main relevant intervention sector)

(Logo of the organisation presenting the project)

Project title

Implementationcountry

OVERVIEW (3 pages maximum, excluding cover page)

THE ORGANISATION

Name of the organization:

Name and details of the contact person:

Full Address:

Tel:e-mail:

Date the NGO was cestablished:

Information about the last three years:

All amounts in EUR or USD only (please specify) / 2013 / 2014 / 2015[1]
Total budget realised
Amount received in private grants
Amount received in public grants
Number of paid employees / volunteers
Number of projects underway

THE PROJECT

Title :

Main Field of involvement (One among : Sustainable Agriculture, Sustainable Fishing, Biodiversity Conservation,Sustainable Technologies):

Summary (3-4 lines):

Precise location (country, region/province, town/villages):

Add one or two small maps showing the location of the implementation area within the province/region, and the province/region within the country.

Main contextual information :

Social-political information

Main problems identified

Historical presence of the project holder in the area

Beneficiaries of the project:

Number and description of direct (concerned by at least one activity) and indirect beneficiaries

If the project is mainly about Biodiversity Conservation, please also indicate the name and the characteristics of the relevant animal or plant species, or of the ecosystem

Project Main objective :

Project Secondary objective(s) :

Descriptive summary of activities to reach objectives :

Total project estimated budget (in Euro only):

The Foundationcan provide up to50% of the total budget for the project, with an average subsidy of € 50,000 per year, over 2 to 4 years. Names of financial partners, Expected (proposal submitted but no reply), Acquired (proposal accepted but agreement not signed) or Confirmed (agreement signed), must imperatively be indicated.

TOTAL / Partner 1[2] / Partner 2[2]… / Fondation Ensemble
Expected/Acquired/Confirmed
Human resources
Cost of activities
Logistics
……..
……..
Total

% of expected funding(=proposal submited but no reply) :

% of acquired funding(=proposal accepted but agreement not signed) :

% of confirmed funding(= agreement signed) :

% of the budget requested from Fondation Ensemble:

Partners on the ground:

Duration:

Expected starting date[3]: Expected completion date:

1

Fondation Ensemble – Concept Note 2016 – SD, SF, BC, ST

[1]If need be, the lastest forecast (budget update)

[2]In the columns " partner 1 ", " partner 2 " and beyond, the names of the financial partners involved in the financial plan must be indicated with the indication E for expected, A for Acquired, and C for Confirmed.

[2]

[3]Unless the submitted proposal refers to an already started project (please provide and explain this start date), the project start date may vary between 1st January 2016, and 1st January 2017 (for the 2016 Call for Proposal).