SAPREF Corporate Social Investment

Funding application form

This document is divided into the following sections:

Section A: Organisational Profile

Section B: Funding Request

Completed applications should be forwarded to the SAPREF CSI representative, by post or email, as follows:

Name: / Londiwe Myeza
Postal Address: / PO Box 3179, Durban, 4000
Contact number: / 031-480 1709
Email Address: /

Declaration of the person submitting the application / report as authorised by the organisation:

Organisation:
Name:
Position / Title:
Signature:
Date of submission:

NOTE: Project should have a clear indication/plan of how the project/s will be implemented, managed and/or evaluated.

Please attach the following documents to the submission
NPO Registration Certificate
Two references from community leaders or organisations that you have worked with on a project in the past
Signed copy of organisation’s constitution
Audited Financial Statement or most recent Financial statement
Proof of organisation bank account
List of organisation’s previous and current donors
Three quotations obtained concerning proposed project activities
Two or three photographs that could be used to better explain motivate

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Section A: Organisational profile /
Name of the Organisation
Non Profit Organisation registration number
Date established
Physical Address
Postal Address
Contact person
Contact person's designation
Cell phone number
E-mail address
Section B: Funding request /
Development sector of intervention (tick applicable option)
Education
Health
Social Development
Entrepreneurial and SMME support
Environment
Training and skills development
Other (Please specify)
Geographic area of project implementation:
Brief description of the project, including what specific part SAPREF funding will be used for
Describe the expected outcomes of the project and explain what will be done to achieve these
How will the project be evaluated and monitored?
FOR SAPREF USE ONLY / Application successful
Date / Application unsuccessful
Date

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