Aga KhanUniversity

University Research Council

APPLICATION FORM

URC Form CBG-1

CAPACITY BUILDING FUNDING

PART 1-Preliminary information

1.To be filled by thePI who may be the Chair or of a Department / Headof an Academic Section or Research Group applying for Capacity Building Funds

Name of the Department leading the application
Principal Investigator
[Name, Designation, Department]

Other AKU departments or AKDN partners / external institutions / organizations/ bodies which are collaborating in case of a joint application.

Collaborator 1
Name
Address
Name of contact
Telephone number
Collaborator 2
Name
Address
Name of contact
Telephone number

Please list any additional collaborators, if any, on a separate sheet.

2.Funding Details

a.Level of funds sought from URC(Maximum limit US $25,000)
b.Funds if any available from other sources to partially support this programme
List sources and amounts of any other contributions. Attach documentary evidence. (Letters of intent are sufficient at this stage.)

Total Value(a+b):(Local currency). ______

3.Purpose: Summarise the purpose (200 words maximum) for which the funding will be used.

4. Authorisation

Signature of the PI Date:

......

Signature Date

......

Head of the Academic Department/Unit /

PART 2-Description

Describe fully the proposal for use of CapacityBuilding funding. Includesections with the following headings (in the order shown) and content. It need not be restricted to theseheadings and additional information may be provided at the end of the section so that all points includedin the Guidelines are covered. Although there is no formal limit on length of the application, theinformation provided should be clear and concise.

5.Purpose for which funding is sought

Describe fully the purpose for which funding is sought.

NB. Also indicate the timeline for spending the funds over a period up to three years.

6.Strategy: Rationale and Benefits

Explain the rationale for the proposal – why your department /section or research group at AKU is applying for this funding and how the proposalcontributes to the strategic aims of AKU.

7.Outputs and Deliverables: Targets and milestones

Explain what would be provided and delivered, by when and by whom. It will help to inform theassessment of the overall value for money of the proposal and provide a basis for subsequent monitoring.

8.Implementation

Explain how the proposal would be implemented.In the case of an external collaborative partner, explain how the relations between partnering institutions will be managedand how the implementation of the proposal would be managed.

9.Self Sustainability

This section should explain the future financial requirements and projections. It shouldalso explain the planning for the long-term financial self-sustainability of activities particularly after the proposed period is over. The case should be presented for why AKU or other sponsor’sfinancial support is needed, and should demonstrate thatcapacity proposed is additional to capacity currently resourced by other means.

10.Year-wise Budget

Item / Year-1 / Year-2 / Year-2

SIGNATURE:______

NAME:______

DESIGNATION:______

Contact:______

[Email & Tel.]

Date:______

Receiving Date:______

[To be filled by Research Office]