GrowCivic

Standard In-kind Support

Request Form

  1. Information about the Requester

Please check those that are relevant:

Yes / No
I am inquiring individually as an activist
I legally reside in Cyprus
(If applicable) I am a Greek Cypriot activist and I am partnering with a Turkish Cypriot activist
OR
I am inquiring on behalf of a CSO
The inquiring CSO is a Turkish Cypriot CSO
The inquiring CSO is working for public good/benefit[1]
(If not working for public good/benefit) The CSO requesting supportis not working for public good/benefit but is partnering with a Turkish Cypriot CSO that works for public benefit
OR
(If a Greek Cypriot CSO) The CSO requesting support is a Greek Cypriot CSO partnering with a Turkish Cypriot CSO that works for public benefit
  1. Contact Person

Name - Surname
Address
District (See Annex 4)
Primary E-mail
Secondary E-mail
Phone Number
Mobile Phone Number
  1. If you are requesting support on behalf of a CSO, please fill in the following information:

Name of CSO
Address of CSO
Name of CSO Representative
District(See Annex 4)
Legal Status of the CSO / a)Association
b)Foundation
c)Charity
d)Chamber
e)Labour union
f)Sports club
g)Federation
h)Confederation
i)Unregistered citizen’s initiative/group
j)Unregistered platform/network
k)Not-for-profit Cooperative
l)Professional Organization
m)Not-for-profit company
n)Other (please explain)
Field of Work(See Annex 1)
Year of establishment/foundation
e-mail of CSO
Telephone No. of CSO
Website of CSO (if applicable)
Facebook page of CSO (if applicable)
  1. (Please answer only if applicable) If the inquirer is requesting support in partnership with others please, fill the following part to provide information about your partner: (Important Note: If the requester is a Greek Cypriot CSO/network/activist OR a Turkish Cypriot CSO/network that is not working for public good/benefit, they have to act in partnership with a Turkish Cypriot CSO/network/activist working for public good/benefit.)

Name of CSO / Activist
Address of CSO / Activist
e-mail of CSO / Activist
Telephone No. of CSO / Activist
District(See Annex-4)
Questions below are only to be filled if the partner is a CSO and not for Activist requesters/partners.
Name of CSO Representative
Legal Status of CSO / a)Association
b)Foundation
c)Charity
d)Chamber
e)Labour union
f)Sports club
g)Federation
h)Confederation
i)Unregistered citizen’s initiative/group
j)Unregistered platform/network
k)Not-for-profit Cooperative
l)Professional Organization
m)Not-for-profit company
n)Other (please explain)
Year of establishment/foundation
Field of Work(See Annex-1)
Is the partner CSO working for public good/benefit? (Yes or No?)
Website of CSO (if applicable)
Facebook page of CSO (if applicable)
  1. Please provide information about the action for which you wish to receive support.

Name of the Action
Field of Action(See Annex 1)
Place where the Action will be implemented (country)
Actions in Cyprus, EU Member States, Countries covered under Instrument for Pre-Accession Assistance (IPA) are eligible
District (if the action is to be implemented in Cyprus) – See Annex 4)
Action Start Date
Action End Date
(cannot be later than 31 January 2018)
Total Duration of Action(See Annex 2)
  1. Please explain the reasons why you request this support; what are the outcomes you wish to achieve? (Briefly select relevant objectives (s) of Grow Civic and explain the outcome(s)/results you want to reach.) Please relate the aim of your action to one or more of the Grow Civic objectives on the following table:

Grow Civic Objectives / Please write the aim of the action you request support for / Please write outcomes/results/outputs of the action you request support for
Increase accountability and visibility of CSOs including measures to support enabling environment
Human Rights and Democracy promotion including citizens’ involvement in policy dialogue, design and monitoring
Reconciliation, dialogue, closer relationship and trust between Turkish Cypriot and Greek Cypriot communities
Expansion of citizen networks and/or support to voluntarism
  1. Please explain and provide details about the aims and outcomes/results of the action you request support for by also covering the rights-based approach[2] you will seek in implementing your action:
  1. Please list the activities you wish to carry out with the support to achieve the outcomes/results and aim(s) of your action? (Describe the implementation phase of action proposed and please write about your plans for thefutureperiod(if applicable) after you complete the activities supported by Grow Civic. Please add as many rows as needed.)

Name of Activity / Start and Finalization Date (month(s) and if known exact date(s) / Place of Action(please use districts listed in Annex 4) / Explanation (please give details of activity proposed: e.g. how long, who will conduct, target group, means and methods, content, outputs)
Activity 1
Activity 2
Activity 3
  1. Who will benefit directly or indirectly from the activity to be supported? Who will be directly involved in the activities conducted (target groups) and who will be benefitting from the results of the action (beneficiaries)? How will the action contribute to improve their situation? (Please list all target groups and beneficiaries with approximate numbers)
  1. Please indicate how the Grow Civic support will enhance/contribute to your capacityfor action.
  1. Have you ever received any EU funding? If yes, please indicate the project reference number, and briefly explain project aims, activities and the amount of funding received.
  1. Please indicate on the following table, if the proposed action will contribute to any of the below targets. For those that are relevant, please briefly explain how this contribution will be made and potentially maintained?

Added Value(s) of the request for support
Targets / Please check if relevant / Explanation
Involvement of / Support to disadvantaged groups and/or people from rural areas
Civil society-public sector and/or civil society-private sector cooperation and dialogue
Mutual learning, co-learning and experience sharing
Gender equality
Environmental Protection
  1. Please write the approximate cost of the activity you wish to be supported.

* Please see Grow Civic Info-Note for eligible and ineligible costs and Annex-3 for set budget items. For in-kind supports the lower limit is 50 EUR and the upper-limit is 3.000 EUR. Please insert the amount for each budget item in EUR currency!

* For TL exchange rate, you can use the InfoEuro rate that you can find at the following address:

Activity (Please use the activity name and number mentioned under question 8 above) / Budget Item[3](please use budget lines listed in Annex 3 of Grow Civic Info-Note) / Budget Details / Budget Total (EUR
1 / Example[4]: Activity 1 Conference / Accommodation costs
Venue costs
Flight tickets for speakers / 20 people x 20 EUR x 2 days
2 days x 150 EUR
2 people x 1 ticket x 300 EUR / 800 EUR
300 EUR
300 EUR
2
3
TOTAL (EUR)

THANK YOU!

[1] Public Good CSOs are those that are created and operated principally to engage in public good/benefit activities and that do not principally work for the interest or needs of its members, founders or persons/groups associated with them (e.g. chambers, unions, professional organizations). CSOs working and operating principally to promote or protect the rights and interests of socially disadvantaged person groups are also accepted as public good CSOs.

[2]Rights-based approach (RBA) is based on the universality and indivisibility of human rights and the principles of inclusion and participation in decision-making processes; non-discrimination, equality and equity; transparency and accountability. The focus of the RBA is on rights rather than needs. The approach is based on the identification of ‘rights-holders’ and corresponding ‘duty-bearers’ in specific contexts, and the promotion of their capacities to claim their rights and fulfil their duties respectively. Hence, it involves elements of cooperation, collaboration, or advocacy towards the relevant duty-bearers relevant with the right that the action aims to enhance.

[3]Please be advised that expert fees are ineligible if and when the service provider/expert is the request owner activist her/himself or is a decision-making member of the request owner CSO/network.

[4]This is an example to provide clear information for requesters. Please fill the form with the budget information that is relevant with your activities and add as many rows as needed.