/ DEPARTMENT OF JUSTICE & CONSTITUTIONAL DEVELOPMENT

Grants Application Form:

Human Rights Awareness

Reference Number: SEJA/HRA 1.5.1/S01

Posted or hand delivered,Applications must be placed in a sealed envelope and the applicant must ensure that the specific reference number as well as the applicants name, address, contact person and contact details are indicated on the outside of the envelope.

Closing date of the Call is 18th September 2015 at 16:00

Emailed Applications must, on a cover sheet, set out the specific reference number as well as the applicant’s name, address, contact person and contact details.

Applications must be typed and completed in English and delivered to:

The Grants Manager

Foundation for Human Rights

Old Trafford 3 Building,

Isle of Houghton,

36 Boundary road

Parktown

Johannesburg

2098

Application may also be posted to:

The Grants Manager

Foundation for Human Rights

Private Bag x124

Braamfontein

2017

Email applications must be sent to:

Applicants must contact the FHR Grants Unit within 5 days of their emails submissions if they have not received confirmation of receipt of submissions.

NB:

  • All applications received after the closing date will be considered with applications for the next closing date.
  • Applicants will be notified in writing of the decision of the Board of the Foundation. Such decisions are final.
  • No Faxed submissions will be considered.
  • All proposals must be submitted in accordance with the instructions contained in this document and must include all information and material requested. Please number the sections of your response to match the numbering given in the Guidelines for Submission.

Proposal Writing Guidelines

Should you require assistance in writing a proposal, we have set out a guide lineentitled: Writing the Proposal on our website.

Click on the link below and look for: Overview of Programme and Funding Guidelines. “Writing the Proposal” can be found on pages 58 – 67.

APPLICATION FORM 2015

AMARIGHTZA- Socio-Economic Justice for All Programme(SEJA)

How did your organization become aware of the Foundation for Human Rights Call for Proposals?

Newspaper Advertisement
Radio
Website
E Mail from FHR
Other (Specify)

Section 1: Organisational Details

1.Organization’s Name: ______

2. Contact Details: ______

2.1 Postal Address: ______

2.2 Physical Address: ______

2.3 Telephone Numbers: ______

2.4 Fax Number: ______

2.5 Email: ______

2.6 Website Address: ______

3. Banking Details:

3.1 Name of Bank where account is held: ______

3.2 Physical address of bank: ______

3.3 Name of bank manager responsible for the account: ______

3.4 Telephone number: ______

3.5 Email address for bank: ______

3.6 Fax number: ______

3.7 Name of bank account: ______

3.8 Branch name and code: ______

3.9 Account number: ______

3.10 Type of account: ______

3.11 Authorized bank signatories of account: ______

______

4. Non- Profit Status

Please provide proof of your organization’s legal and non-profit status.

5. Project Details

5.1 Contact person: ______

5.2 Person authorized to sign on organizations behalf: ______

5.3 Financial manager: ______

5.4 Authorized Signatory to bank account: ______

5.5 Contact details of financial manager and authorized signatories to bank account:

______

5.6 Statutory Auditors to Programme: ______

5.7 Physical Address for Auditors: ______

5.8 Telephone number: ______

5.9 Email Address: ______

5.10 Person responsible for Audit at Statutory Auditors: ______

6. Employees at the Organisation

Please complete the table below.

Include details of all staff members and indicate whether they are part-time, full- time or volunteers.

Name of Staff / Position / Race / Gender / Disability / Number of years / Full time/part time/
member / employed / volunteer

7. Board/ Management Committee Members

7.1 Names of Board/ Management Committee Members/ how long have they been on the board and / or on the management committee.

Names of Board Member / Position on the Board, I e Chair/Treasurer / Telephone/Email contact Details / Period served on the Board(years served)

Section 2: Project Proposals

  1. Please indicate which Call for Proposals you are responding to and quote the reference number.

______

  1. Please indicate the core business or activities usually undertaken by your organization.

______

  1. Please write a brief history of your organization (not more than a page)
  1. Project Information

1.1Name of your project:______

1.2Projectdescription:______

1.3Brief statement of the human rights problem that this project intends to address:

______

1.4Goals and objective of your project describe what you hope to achieve

______

1.5Explain how these objectives will contribute towards advancing human rights and in particular the aims and objectives of this call

______

1.6A description of the area(s) in which the organization works (including municipality, province, nearest town/ city, urban or rural area)

______

1.7Target population and area/ community where you intend to implement the project

______

1.8Identify the key stakeholders and partners for this project

______

1.9Describe the political, social, and economic environment or context in which the project is to be implemented

______

1.10What strategies do you intend to use in implementing your project

______

1.11Give a short description of the primary beneficiaries/ target communities who will benefit from the implementation of the project.

______

1.12Explain how your beneficiaries and/ or target group were identified.

______

  1. State the Project Purpose

2.1Clearly state what your project intends to achieve and how the target group and/ or beneficiaries will benefit.

______

2.2List the project activities that you will undertake through this project

______

2.3Describe how you intend to implement the activities set out in the implementation plan

______

2.4List the results you anticipate that you will achieve from this project.

______

2.5What are the potential risks and threats that may prevent he project from succeeding?

______

2.6What strategies will you put in place to mitigate these potential risks and threats?

______

  1. Implementation Plan:

Describe how you intend to implement the activities set out in the implementation plan below and provide reasons for your proposed strategy.

Month / Activity / Duration / Where / Who / How

4. Staff Capacity to implement Project.

Set out the human resource capacity within your organization which will allow the effective delivery of this project.

Name of Staff Member / Designation / Project Related Duties / Number of years in the organisation

5. Project Results and/or Outputs

Please set out the project results/outputs that you hope to achieve through the project.

It is importantto link the project results/outputs to the project activities.

Project Activity / Results/Outputs to be achieved

6.Monitoring and Evaluation of the Project

The term ‘Monitoring and Evaluation’ refers to two distinct sets of organizational activities, which are related but are not identical.

What is Monitoring?

Monitoring is the systematic collection and analysis of information as a project progresses. It is aimed at improving the efficiency and effectiveness of a project or organization. It is based on targets set and activities planned during the planning phases of work.

It helps to keep the work on track, and can let management know when things are going wrong. If done properly, it is an invaluable tool for good management, and it provides a useful base for evaluation.

It enables you to determine whether the resources you have available are sufficient and are being well used, whether the capacity you have is sufficient and appropriate, and whether you are doing what you planned to do.

What is evaluation?

Evaluation is the comparison of actual project impacts against the agreed strategic plans. It looks at what you set out to do, at what you have accomplished, and how you accomplished it.

Having read our brief outline of Monitoring and Evaluation, describe the monitoring and evaluation process that will be used to record progress in respect of the project, its activities, the results and success of the indicators, as well as the project impact on the beneficiary/target community.

______

7. Sustainability

7.1Describe how the organization intends to sustain the project activities and delivery of results and benefits beyond the funding period of the FHR.

______

7.1Explain how the beneficiaries were involved in the planning of the project and how you intend to establish/continue a meaningful relationship.

______

7.2Are you receiving any other funding for this project or have you applied for funding to other donors for this project?

Name of Donor / Amount applied for / Amount Received / Period funding is requested for

8Budget

8.1Your application is only complete if it contains a budget setting out the necessary financial information.

8.2All the activities and expenses related to the project need to be included. Furthermore, you need to show the total cost of the project and not only the areas of work for which you are seeking funding from the FHR.

  • Please provide a detailed budget, linked directly to your implementation plan for each of the proposed activities.
  • Indicate clearly what proportion of this budget is requested from the FHR.
  • The budget template below can be adapted to suit the specific requirements of each project.

Item / Unit Cost / Number of Units / FHR % / Total
Total

Notes on the budget and funding

  • The administration fee cannot exceed 10% of the amount requested from the FHR.
  • Every grant applicant is required to contribute from own their funds to the project budget. In exceptional circumstances, applications for funding for 100% of the budget may be considered at the sole discretion of the FHR. Such applications must be properly motivated.
  • The FHR will not finance the purchase of any fixed assets, such as land, buildings or equipment of a permanent nature and/or structure and will also not fund renovations.
  • Please note that all budgets must be calculated in Rands.

9Partnership Information

Partners are organizations that participate with you in the implementation of the contract and that you may share your grant with. Any actors that are not named as partners and that do not sign the declaration of partnership may not share the grant with you and can only receive money through contracts awarded in line with the procedures or via per diem/stipends as participants in trainings, as field workers, etc.

Please note that you, as the lead applicant, are the sole contracting party to the contract with the FHR and are thus liable for all and any contractual issues that may arise.

9.1Please provide the full details of the partnership organization

9.1.1Name of organization: ______

9.1.2Acronym:______

9.1.3Legal status: ______

9.1.4Official physical address: ______

9.1.5 Contact Details

Telephone: ______

Email: ______

9.2 Reasons and/or motivation for preferred partner

9.2.1 Previous experience of partner organization in this sphere of developmental work

______

9.2.2 Previous experience of working in the human rights sector

______

9.2.3Previous relationship with preferred partner

______

9.2.4Challenges faced in implementing past projects with the preferred partner

______

9.2.5Please detail the role that you envisage the preferred partner will play in the management and implementation of the project.

______

10. What the FHR Looks for when Assessing Proposals

The FHR will keep the following questions in mind when assessing your proposal:

  • How does your project serve vulnerable and marginalized communities?
  • How will it empower them? Will they be passive recipients or will it enable them to take control of their lives?
  • Will your project lead to changing society, not just helping individuals, but through having an impact on policy and legislation or a change in culture and attitude in communities?
  • Will this project contribute to building best practice?
  • Is it sustainable?
  • Will the funding be an effective use of resources?
  1. General

11.1Please provide one originaland one copy. Only one copy of supporting material is required. Where discrepancies between copies occur, the hard- copy original will be assumed to be correct.

11.2Applications submitted by fax will not be assessed.

11.3Any failure to disclose material information, a factual inaccuracy, and/or a misrepresentation of any fact may result in the disqualification of your submission, or the cancellation of any subsequent contract.

11.4Any undue influence or attempt to unduly influence the employees or agents of the Foundation will result in the automatic disqualification of your submission, or the cancellation of any subsequent contract.

All queries must be communicated in writing via email to

Applications shall be emailed or submitted at the emailaddress: no later than 16h00 of the submission date.

DECLARATION

(This section MUST BE COMPLETED AND SIGNED by the person duly authorised to do so)

I, (full name) ______declare that I am authorised by ______(Organisation’s name) to act as its authorised officer and to enter into agreements on its behalf.

I commit myself to ensuring that all funds will be used for their intended purpose.

Signature: ______

Full names:______

Position:______

As witness:______

Date:______

Place:______

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