To the
Consulate General of the
Federal Republic of Germany
Bangalore / Rubber stamp of institution

A p p l i c a t i o n

for financial support in implementing a micro-project

Information on the institution
1. / Name of the institution:
Contact person:
Address:
Telephone/mob. phone: / E-mail:
2. / Legal form of the institution, year of establishment, number of members
(please attach copy of registration certificate)
3. / Description of the institution’s activities:
4. / Organisations that have supported the institution’s projects in the past
Information on the project
5a) / Project title:
5b) / Short description of the project
please attach summary and photos
5c) / Target group and number of persons/families who would benefit from the project:
5d) / Goals of the project
(improvement of social and economic situation, education, insertion in the labour market etc. – if applicable also with a view to tangibly improving women’s lives in the area)
Information on the project financing
6a) / Financing plan enclosed / yes / no
6b) / Is overall financing (including grant of the Consulate General) guaranteed? / yes / no
7a) / Amount applied for at the Consulate General / Rupees
7b) / Own funds and third-party funds / Rupees
7c) / Total cost of project (please attach 2 quotations) / Rupees
7d) / Other contributions by applicant to project implementation (e.g. work, land or buildings.)
7e) / Follow-up costs (please specify)
7f) / How are these costs to be covered?
Information on the duration of the project
8. / Project / has not yet
commenced / commenced on
9. / Project start: / Project end:
10. / Have you applied for or received any other public funds for this project?
yes / no
If so, from which institution and how much?
Place, date / Signature 1
Name and Designation / Signature 2
Name and Designation