INSTRUCTIONS HOW TO FILL IN THE APPLICATION

This application form has a certain format, and applicant shall ensure that application will include the following:

ü  Be completed in a computer;

ü  Be in Albanian, Serbian or English;

ü  No longer than 20 pages (A4), without annexes. To have an answer on each question and section provided below;

ü  Grant duration cannot exceed 24 months;

ü  Institutional grants budget form. Do not attach other forms;

ü  NGO Registration Certificate;

ü  Declaration on the Conflict of Interest;

Application shall be submitted in one (1) original and one (1) copy of A4 format. The completed application documents should also be submitted in electronic form (CD);

The completed applications should be submitted to KCSF offices. The wording in the envelope shall contain the following text: “DSP institutional grant application, full name and address of applicant”;

Applications will be received every working day, from 10:00 hrs. to 16:00 hrs.; on Fridays until 14:00 hrs.

Address for the submission of applications:

Kosovar Civil Society Foundation - KCSF

Fazli Greiçevci 55, 10000, Prishtina, Kosovo

APPLICATION DEADLINE

Date: 15 March 2016

Time: 16:00 hrs.

CHAPTER 1: Organization details

Organization details (not longer than 2 pages)

Applicant No. / To be completed by KCSF / Application date: / To be completed by KCSF

ORGANIZATION IDENTITY

Name of applicant: / Full legal name (acronym)
Legal status: / Foundation or Association
Registration No. / Registration No.
Establishment date:
VAT Number
Fiscal Number:
Address: / Street, Number, Postal Code, village/city
Telephone number: / Land line and mobile
Executive Director: / Name and surname - E-mail address
Website: / www.
Bank details: / Name of bank and account number
Current staff: / Number of staff members (full time, part-time, volunteers)
Budget in 3 last years / 2015: EUR ... 2014: EUR ... 2013: EUR ...
Key donors: / Indicate 5 key donors as per their donations amount
Relevant experience: / Enlist three main projects related to the program[1] you are applying for. (project title, amount and implementation year)

KEY INFORMATION FOR THIS APPLICATION

Title of program/strategy you are applying for: / “ ”
Duration: / How many months? DD/MM/YY - DD/MM/YY . Institutional grants should be concluded at the latest by 30 May 2018.
Amount requested from DSP: / EUR ...
Location: / Indicate the region, city, village or neighborhood.
Program/strategy goal: / Please describe briefly in one paragraph the program/strategy goal or the expected change.


CHAPTER 2: ORGANIZATION PROFILE

Ø  Mission (describe the mission of your organization, as defined in the Statute):

Ø  Management structure (describe management bodies of organization and give names of key Assembly and/or Board members, as well as its executive management:

Ø  Decision-making (describe the decision making for key decisions in your organization):

Ø  Scope (enlist not more than 3 priority activity fields of your organization):

Ø  Short description of programs (describe key organization programs, their scope and key activities):

Ø  Approach to the development of programs/projects (describe how the organization programs and projects are developed; who is involved in their designing and implementation; how is their implementation evaluated):

Ø  Networking (Are you a member of a formal or non-formal network in Kosovo and abroad? If yes, please indicate).


CHAPTER 3: ORGANIZATION PROGRAM (for which institutional grant support is requested)

Ø  Description of program/strategy/activities in last 3 years (not more than 2 pages)

(When was the program launched? What projects/activities were undertaken by the organization in the last 3 years within this program? Which were the main achievements of the program? Which are the main challenges of the program? If newly launched program, describe reasons for its launching and the way how it was launched?)

Ø  Target groups (not more than 1 page)

(Who are the target groups of this program and is there any change going to happen for these groups in case of benefiting from the DSP? Which is their role and benefit in the development and implementation of the program?)

Ø  Strategy and annual plan goals of the organization (not more than 1 page)

(Which are the general goals of organization strategy? Which are the goals of a specific program you are applying for? Which will be the key achievements of specific program you are applying for through DSP?)

Ø  Planned activities, including implementation strategy and approach (not more than 3 pages)

(Enlist key planned activities for this program, including the strategy and implementation approach for each activity)

Ø  Expected results (not more than 2 pages)

(Indicate and describe the results you plan to achieve through your program activities? Relate them to planned activities and expected results from the DSP)

Ø  Internal quality control mechanisms (not more than 1 page)

(Describe the coordination, reporting, oversight and internal evaluation of program and activities?)

Ø  Risk factors and program sustainability (not more than 1 page)

(Describe risk factors that may impact the program implementation. Describe measures to cope with these risks. How will you ensure sustainability of this program/strategy following the end of DSP support?).

CHAPTER 4: EXISTING CAPACITIES OF ORGANIZATION

Ø  Human resources:

Number of full time staff members
Number of part time staff members
Number of volunteers

Ø  Staff member skills (Describe staff member skills and their expertise):

Name and surname / Position / Skills and expertise

Add columns if need be

Ø  Describe technical equipment in the possession of organization:

Type of equipment / Number / Condition

Add columns if need be

Ø  Financial situation

Indicate organization’s annual budget for the last three years:

2013 / 2014 / 2015

Ø  Financial Management

(Which financial management system is used by the organization? Who is responsible for financial planning and management?):

Ø  Capacity Building Needs

(Indicate the organization capacity building needs, including trainings, research skills, assistance at work, strategic planning, etc.):

Ø  Other important information (not more than 1 page)

(Indicate any other information not mentioned above, which you consider to be important for a proper evaluation of your application):


CHAPTER 5: FUNDING

Ø  Funding sources and amounts in last 3 years (please indicate funding amounts of your organization in the last 3 years):

Funding source / Funding source category[2] / Funding amount for 2013 / Funding amount for 2014 / Funding amount for 2015 / % of the total amount of annual budget for 2015
Total / 100%

Ø  Other institutional/core grants, if any, for the application period? (please indicate funding sources and amounts for next 2-3 years):

Institutional or core grant donor / Grant type / Amount for 2016 / Amount for 2017 / Amount for 2018 / Total for the next 3 years?
Total:


MANDATORY ANNEXES [3]

1.  Registration Certificate and Fiscal Number Certificate of your organization;

2.  VAT Certificate (if available);

3.  Organization Statute;

4.  List of Board members and /or heads of the Assembly of Members;

5.  Organization strategy, including the program you are applying for;

6.  Annual Work Plan;

7.  Resumes (CVs) of persons responsible for grant implementation;

8.  Budget together with salary specification and reasoning;

9.  Financial balance statements or Auditor’s reports for last two (2) years.[4]


Conflict of Interest

1. Is there any conflict of interest between the organization staff members or people who will be working with the project and members of Grants and Awards Board (GAB)?

Indicate YES or NO

2. If YES, with which GAB member you are in the conflict of interest?

Saranda Cana / If in conflict of interest, indicate your relation
Anamari Repić / If in conflict of interest, indicate your relation
Edis Agani / If in conflict of interest, indicate your relation
Ertan Munoglu / If in conflict of interest, indicate your relation
Rinor Beka / If in conflict of interest, indicate your relation

Definition:

Conflict of interest- is a situation of incompatibility between mandated duty and private interest of a GAB member, when he/she has direct or indirect private personal or property interests that may influence or seems to influence his/her legitimacy, transparency, objectivity and impartiality during the discharge of Grants and Award Board (GAB) responsibilities.

Note:

In case of conflict of interest, the relevant GAB member will not be involved in the review of application submitted by an applicant with whom he/she is in conflict of interest. Other than this, the application evaluation procedure will be carried through a regular procedure.

[1] Institutional support could be for a program or the entire organization.

[2] E.g. membership fees, economic activity of organization, central/local government, individuals, private company, local/international donors, etc.

[3] All mandatory annexes should be presented as separate documents listed in order from 1 to 9.

[4] Auditors report must include all financial statements.