Template 1

Template - PROGRAM PROPOSAL & FUNDING APPLICATION

INTERNATIONAL DEVELOPMENT PROGRAMS

To ERFA for 2018 CALENDAR YEAR

INSTRUCTIONS

  • Throughout this document, ERFA refers to Edmund Rice Foundation Australia
  • This form is an interactive Word template and must be completed by the Program Leader
  • We recommend you TAB through this form to ensure all sections are completed but you may also click to select a field
  • Before completing this form, ensure that you are familiar with ERFA Funding Policy
  • All ERFA Policies are available on ERFA website at
  • Please complete all sections of this form
  • A separate budget must be submitted with this application utilising the Budget Template available under the “Program Toolkit” menu at
  • A separate application must be completed for Capital Funding using the Capital Funding Application template available under the “Program Toolkit” menu at
  • Please email the completed application and attachments to prior to 31 August 2017

BACKGROUND INFORMATION FOR APPLICANTS

ERFA Appraisal of Funding Applications

ERFA Funding Application Review Committee undertakes appraisal of Funding Applications under two broad criteria:

  • Appraisal of Program Design
  • Appraisal of funding applicant’s Capacity to Implementtheir proposal

Hence, the information requested in this application form is organised under these two criteria.

What is Appraisal?

  • Appraisal is a critical and quality assessment (or evaluation) of a program proposal against pre-defined criteria
  • The term appraisal is used at the funding application phase to distinguish it from the evaluation which is conducted at the end of the funding cycle

APPLICATION TEMPLATE CONTENTS

PART 1: PROGRAM DESIGN

AProgram Details

BProgram Identification & Design

  • Vision & Mission
  • Program Background
  • Development Needs
  • Development Objectives
  • Beneficiaries
  • Beneficiary Participation in Program Design
  • Program Plan
  • Program Approvals

CCross Cutting Issues

DRisk Management

EMonitoring & Evaluation

FWelfare

GComplaints Handling

PART 2: CAPACITY TO IMPLEMENT

HGovernance

IStrategy

JLeadership / Management

KFinancial Management

LSustainability

MPartnerships & Networking

NHuman Resources

OResources & Logistics

PART 3: SUPPLEMENTARY CRITERIA & INFORMATION

PBank Account Details

QReporting to ERFA

RRecognition of ERFA

SAuthorisation of Funding Application

Supporting Documentation Checklist

Initial Assessment of Application – for ERFA use only

PART 1: PROGRAM DESIGN

A PROGRAM DETAILS

A1 / Program Title
A2 / Program Location / Country
A3 / Governing Authority
A4 / Chair of Governing Authority
& Contact Details / Name:
Telephone:
Email:
A5 / Program Manager – Name / Title
A6 / Program Manager Contact Details / Telephone:
Email:
Address:
A7.1 / New Program - Program Duration
How long will the program run for? / Proposed Start Date:
Proposed End Date:
A7.2 / Established Program - Duration / NA (For established programs it is assumed that funding is for the following calendar year)
A8.1 / Total Program Budget for 201_
Please specify currency
A8.2 / Total ERFA Funding Requested
Please specify currency
A8.3 / Program Budget Attachments
[All Budgets and Budget Forecasts must specify what income is to be dedicated to development activities and what income is to be dedicated to welfare activities (see F1 below for clarification of Welfare)] / Please attach the following:
  • Total Budget (Use online Program Budget Template)

A8.4 / Budget Forecast / Please complete the table below. Please specify currency.
Currency / Forecast Total Budget / Forecast ERFA Funding Required / Explanation of any variation
2018
2019
2020
A9 / Total Cumulative Funding
If ERFA not sole funder
Please specify currency / Donor / Funding Amount
A10 / Is this program part of an ongoing program? If yes, please provide details.

B PROGRAM IDENTIFICATION & DESIGN

B1 Vision & Mission
ERFA wishes to confirm consistency between its Vision and Mission and that of funding applicantsPlease tick ONE of the boxes below regarding your organisation’s Vision and Mission Statements
Our organisation’s Vision & Mission Statements are attached to this application ☐
Our organisation’s Vision & Mission Statements have been provided to ERFA previously ☐
Our organisation does not yet have Vision or Mission Statements ☐
B2 Program Background
Please outline any relevant background to the program
e.g. any relevant social, economic and/or cultural factors in the local context
B3 Statement of Development Needs
What is the development issue(s) you are planning to address?
Describe the process by which this issue (or these issues) was / were identified and assessed
B4 Statement of Development Objectives
What is your main development objective?
State any secondary objectives that support the main objective
B5 Beneficiaries
Who will be the program beneficiaries?
B6 Estimated Total Beneficiaries and Gender / Age Profiles
Please complete the chart below
Gender / Age / Estimated Totals
Women
Men
Girls
Boys
Women with a disability
Men with a disability
Girls with a disability
Boys with a disability
Estimated Total Beneficiaries
B7 Beneficiary Participation in Program Design
Definition: Program Design involves the identification of communal problems, their causes and consequences and the planning of interventions.
Expectation: ERFA expects programs to be designed in partnership with target communities and evolve from community engagement and participation.
Use the chart below to provide information about how program beneficiaries participated in the identification and assessment of their community’s needs and how they participated in program design
Beneficiaries / Type of Participation in Program Design
B8 Program Plan – Overall Strategy
What is your overall strategy to achieve your program objective(s)?
B9 Program Plan – Outputs, Outcomes & Implementation Timeline
Please complete the table below detailing your planned program outputs and describe the expected outcomes for the target beneficiaries.
Please include the implementation timeline for the planned outputs.
An example is provided here for a Healthy Communities Program in a developing country rural context:
Outputs / Implementation Timeline / Outcomes
Select & train 12 Community Water Workers to dig and cover wells and maintain and repair hand pumps / February - April / Improved access to & use of safe water & decreased incidence of waterborne diseases
Train existing Community Health Workers (CHWs) to increase their knowledge of waterborne diseases & good hygiene practices / February / CHWs upskilled & knowledge base increased enabling improved promotion & monitoring of community health
CHWs to conduct community workshops in good hygiene practices / March - May / Raised community awareness & use of good hygiene practices & improved community health
Outputs
(Planned activities through which outcomes will be achieved) / Implementation Timeline / Outcomes
(Predicted impacts for target beneficiaries)
B10 Program Approvals
Please list below any approvals required for undertaking this program and identify the relevant authority (e.g. civic, education, health, church, governing authority) and indicate if the approval has been obtained
Please attach copies of all approvals
Program Approvals
Approval / Approving Authority / Approval Obtained
YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
B11 ERFA Design, Monitoring & Evaluation Policy
Is your program leadership familiar with ERFA’s Design, Monitoring & Evaluation Policy?
YES ☐ NO ☐

C CROSS CUTTING ISSUES

C Cross Cutting Issues
Cross Cutting Issues are integral to development and have strong impacts on development
For each of the 5 Cross Cutting Issues below:
  • name any relevant program site policy which addresses the cross cutting issue
  • outline your planned initiatives to integrate the cross cutting issue into your program

C1 Child Protection
Relevant Policy:
Please attach a copy of your Child Protection Policy
Name of Program on-site Child Protection Officer:
Planned Integration Initiatives:
C2 Gender Equality & Female Empowerment
Relevant Policy:
Planned Integration Initiatives:
C3 Disability & Inclusiveness
Relevant Policy:
Planned Integration Initiatives:
C4 Protection of Human Rights
Relevant Policy:
Planned Integration Initiatives:
C5 Environmental Sustainability
(Areas to consider with potential for negative environmental impact: flora & fauna, waterways, waste disposal, energy use, noise, pedestrian & vehicular traffic flows)
Relevant Policy:
Planned Integration Initiatives:
C6 Cross Cutting Issues – Professional Development
In the box below, provide information on any planned staff professional development in cross cutting issues
Planned PD / Participants / Planned Date(s)
C7 ERFA Cross Cutting Policies
Is your program leadership familiar with ERFA’s Cross Cutting Policies?
Child Protection Policy & Procedure
Gender Equality & Female Empowerment Policy
Diversity & Inclusiveness Policy
Sustainable Development Policy / YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐

D RISK MANAGEMENT

D1 Risk Management Framework
Please complete the Risk Management Framework below or attach your program’s Risk Management Framework.
Are you attaching a Risk management framework? YES ☐ NO ☐
A Risk Management Framework must be submitted for a program to be eligible for ERFA funding
Risk treatment
Likelihood: Unlikely, Possible, Likely, Almost Certain
Impact: Insignificant, Minor, Moderate, Major, Extreme[Impact = consequences for projectif risk occurs]
Identification of potential risks should take into consideration the specific nature of the program
Risk categories offered for consideration
  • Unpredictable in-country environment: e.g. political, legal, civil unrest, variable exchange rate
  • Budget forecasts inaccurate
  • Corruption / fraud
/
  • Child protection breach
  • Human rights violation
  • Environmental degradation
  • Implementation schedule disrupted
  • Program outputs below quality
  • Stakeholder conflict and / or disengagement
/
  • Authority and / or communication issues – leadership / staff / stakeholders
  • Staff instability / turnover
  • Resource shortfall

Risk Management Framework
Risk Description / Likelihood / Impact / Mitigation Strategies
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
select / select /
D2 ERFA Risk Mitigation Policies
Is your programleadership familiar with ERFA’s Risk Mitigation Policies?
Anti-Corruption & Anti-Fraud Policy
Counter Terrorism Policy
Safety & Security Policy / YES ☐ NO☐
YES ☐ NO ☐
YES ☐ NO ☐

E MONITORING & EVALUATION

E1 Program Site Monitoring Plan
Complete the table below
Aim: systematic collection & analysis of information for management control & decision making
Monitoring:focuses on activities / outputs (i.e. implementation progress – see B9 above)
An illustration is provided here building on the Program Plan – Outputs & Outcomes example in B9 above:
Outputs / Quantitative Indicators / Data Collection Methods / Frequency / Responsibility
Select & train 12 Community Water Workers to dig and cover wells and maintain and repair hand pumps / Number of new wells completed & functioning
Number & frequency of maintenance carried out on completed wells / Number of new wells certified byDistrict Water Authority
Wells Maintenance Log / Bi-monthly
End of every month / Wells Construction & Maintenance Co-ordinator
As above
Train existing Community Health Workers (CHWs) to increase their knowledge of waterborne diseases & good hygiene practices / Number of training sessions conducted
Number of attendees
Number of CHWs who successfully completed training
Training Program Content / Training Program Plan
Attendance Register
Training Certification Register
Review of Training Program Plan / End of training course
Bi-weekly
End of training course
End of training course / Community Health Co-ordinator (CHC)
As above
CHC & Program Leader
As above
CHWs conduct community workshops in good hygiene practices / Number of workshops conducted
Number of participants
Workshop content / Workshop Schedule
Attendance register
Review of Workshop Plan / Monthly
Monthly
Monthly / CHC & Program Leader
CHC
CHC & Program Leader
Program Site Monitoring Plan
Outputs
(see B9 above) / Quantitative Indicators
(e.g. date of completion or specific measure) / Data Collection Methods
(e.g. survey, records, statements) / Frequency / Responsibility
E2 Program Site Evaluation Plan
Complete the table below
Aim: systematic collection & analysis of information for management control & decision making
Evaluation: focuses on outcomes / impacts (i.e. progress in achieving objective(s) – see B9 above)
An illustration is provided here building on the Program Plan – Outputs & Outcomes example in B9 above:
Outcomes / Qualitative Indicators / Data Collection Methods / Frequency / Responsibility
Improved access to & use of safe water & decreased incidence of waterborne diseases / Improved access to safe water
Improved water quality
Reduced morbidity & mortality due to waterborne diseases / District Water Authority Certification Register of new wells & water quality testing records
Community Medical Clinic records / Every 6 months
Every 6 months / Wells Construction & Maintenance Co-ordinator
Community Health Co-ordinator (CHC)
Community Health Workers (CHWs) upskilled & knowledge base increased enabling improved promotion & monitoring of community health / Number of CHWs who have successfully completed training
CHC evaluations of CHW conducted community workshops in good hygiene practices / Program Training Certification Register
CHC & Program Leader observation of community workshops / At end of training courses
Minimum of 2 workshops observed per month / CHC
CHC & Program Leader
Raised community awareness & use of good hygiene practices & improved community health / % increase in number of households using safe water supplies / Household Surveys / Quarterly / CHC
Program Site Evaluation Plan
Outcomes
(see B9 above) / Qualitative Indicators
(e.g. survey, participation rates, impacts) / Data Collection Methods / Frequency / Responsibility

F WELFARE

F1 Welfare
Please respond to each of the questions in the chart below
Note: the inclusion of welfare activities in your program does not automatically disqualify your program from ERFA funding
Welfare Activities
Does your program include:
  • Provision of direct assistance to individuals?
  • Provision of food, clothing, materials such as scholarships, school fees, books etc.?
  • Institutionalised care such as orphanages or hospital care?
  • Giving funds directly to children or families?
/ YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
YES ☐ NO ☐
Do you intend to utilize any ERFA funding for welfare activities? YES ☐ NO ☐
If you answered YES to the previous question, describe how these activities are necessary for the achievement of your program’s development objectives (stated in Section B4 above)
F2 ERFA Non Development Activity Policy
Is your program leadership familiar with ERFA’s Non Development Activity Policy?
YES ☐ NO ☐

G COMPLAINTS HANDLING

G1 Complaints Handling
Program site Complaints Handling Policy & Procedures
Does your Program have a Complaints Handling Policy in place? YES ☐ NO ☐
Are your complaints handling procedures visible for all associated with the program in both English and the local language? YES ☐ NO ☐
G2 ERFA Complaints Handling Policy
Is your program leadership familiar with ERFA’s Complaints Handling Policy YES ☐ NO ☐

PART 2: CAPACITY TO IMPLEMENT

H GOVERNANCE

H1 Governance Structure
Please provide a description of your program’s governance structure. Include the following:
  • Identity & legal status of governing authority
  • Governance structure – e.g. board or equivalent
Please attach a copy of your governing authority’s governing instrument (e.g. constitution)
H2 Governing Body
In the table below, please provide the names and positions of all members of your program’s governing body (i.e. board or equivalent)
Governing Body positions to include: Chair, Deputy Chair, Secretary, Treasurer, Board Member or Director
Name / Position

I STRATEGY

I1 Strategy
Please respond to the questions below regarding your organisation’s strategic planning
Please attach a copy of your organisation’s Strategic Plan or strategy document, unless the most recent edition has been provided to ERFA previously
Does the program for which you are requesting funding form part of an overall Strategic Plan or strategy document? / YES ☐ NO ☐
Has the most recent edition of your organisation’s Strategic Plan or strategy document been provided to ERFA previously? / YES ☐ NO ☐
If you answered NO to the previous question:
Is a copy of the most recent edition of your organisation’s Strategic Plan or strategy document attached to this application? / YES ☐ NO ☐ N/A ☐

J LEADERSHIP / MANAGEMENT

J1 Leadership / Management
Please describe the leadership and management structure and systems in place for the delivery of your program
Your leadership and management structures and systems should be appropriate for the size and scope of your program

K FINANCIAL MANAGEMENT

K Financial Management
Please respond to the questions below regarding the internal financial management system(s) in place for your program
The financial management system should be appropriate for the size and scope of your program
K1 Is your program utilizing the Edmund Rice Development – Edmund Rice Foundation Australia Mission Finance Manual’s systems and procedures for your program’s financial management?
YES ☐ NO ☐
K2 If you answered NO to J1 above, please provide details of your program’s internal financial management systems and procedures. You should include:
  • Budget preparation system
  • Segregation of duties and authorisation and signature requirements for transaction approvals
  • Financial documentation and record keeping
  • Cashbook system
  • Banking arrangements
  • Monthly processes

K3 Please indicate the arrangements in place for annual, external, independent audit of your program’s accounts
K4 In the table below, please identify the person(s) responsible for your program’s financial management and their position(s) and responsibilities
Staff Member (full name) / Position & Responsibilities

L SUSTAINABILITY

L1 Sustainability Plan – Program Outcomes
Provide information on how planned program outcomes will be sustained past the program lifetime and how the target community will be able to sustain the program outcomes beyond that lifetime
L2 Sustainability Plan - Funding
Provide information on any potential alternative funding sources that have been identified, especially any potential in-country sources

M PARTNERSHIPS & NETWORKING

M1 Partnerships
Are you working in partnership with other NGOs, civic or private sector entities? If yes, please provide details of these partners and their roles and responsibilities
M2 Networking
Are you aware of other programs (NGOs) with similar objectives, outputs and outcomes in your area? If so, are you collaborating with them? If so, how?

N HUMAN RESOURCES

N1 Program / Staff Handbook / Manual
Does your program have a program or staff handbook or manual? YES ☐ NO ☐
If YES, please attach a copy of your Handbook / Manual
N2 Policies for Protection of Program Participants, Staff & Volunteers
Please list below any program site policies for the protection of program participants, staff & volunteers and attach copies with your application
N3 Staffing - Key Program Personnel
In the table below, please identify the program personnel responsible for program delivery and their positions and responsibilities
Key Program Personnel (full name) / Position & Responsibilities

O RESOURCES & LOGISTICS