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Project Application Form: Income Generating Activities

This document is a project application form for income generating activities. It requests information over several sections: [1] General project data; [2] Details about the community and beneficiaries; [3] A description of the proposed project objectives, activities, timeline and costs; [4] Details on the community contribution; [5] Information on the implementation capacity and management committee; and [6] Plans for project sustainability. The form is used to apply for grants from the Rural Social Development Fund for proposed income generating projects.

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106 views10 pages

Project Application Form: Income Generating Activities

This document is a project application form for income generating activities. It requests information over several sections: [1] General project data; [2] Details about the community and beneficiaries; [3] A description of the proposed project objectives, activities, timeline and costs; [4] Details on the community contribution; [5] Information on the implementation capacity and management committee; and [6] Plans for project sustainability. The form is used to apply for grants from the Rural Social Development Fund for proposed income generating projects.

Uploaded by

aptureinc
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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INCOME GENERATING ACTIVITIES

PROJECT APPLICATION FORM

Date of Application:

TO BE FILLED IN BY THE RSDF STAFF


Village/commune/county:
Type of the project
Date of application
Requested RSDF grant
Code of the project

Date of the application form:

PLEASE NOTE: BEFORE FILLING IN THIS FORM READ THE GUIDELINES


ON INCOME GENERATING ACTIVITIES.

The application form as well as the Business plan (the standard forms are provided by the
RSDF) should be filled in two copies. One copy shall be sent/ brought to the RSDF
together with the documents mentioned in Section G of this Project Application Form.
The second copy shall remain with the applicant.

The Application form and the Business plan should be filled in as legibly as possible.

Incomplete documents or documents sent after the competition round deadline will not be
taken into account.

Documents sent shall not be returned to applicants.

PLEASE NOTE: FILLING IN OF THIS FORM IN NO WAY GUARANTEES


THAT YOUR PROJECT WILL BE FUNDED.

Project application is within the ceiling of US 20000

The contribution of the beneficiaries is of minimum 15% of the value of the grant
requested from the RSDF. The project value equals the value of the grant plus the value
of the local contribution. Other financial contributions are also welcomed.

The grant shall be disbursed in three tranches, as follows:


 The first tranche representing 25 % of the grant shall be paid as advance payment
after signing of the Grant Agreement.
 The second tranch representing 60% of the grant shall be paid subject to the
beneficiary accounting for at least 75% of the amount of the first tranch, in
accordance with the favorable report elaborated by the RSDF supervisor. Requesting
the third tranch shall make justification of the remaining 25% of the advance
payment.
 The third tranch representing the remaining 15% of the grant shall be paid subject to
the beneficiaries accounting for 75 % of the amount of the second tranch.
Justification of the remaining 25% of the second tranche as well as of the third tranch
shall be made at the closing of the project.

Section A: GENERAL DATA

1. Name of Project:

2. Commune/Village:

County:
3. The Project Management Committee
Manager …………………………
Secretary ………………………….
Treasurer …………………………

4. The value of the grant requested (the amount requested from the RSDF) in US
dollars, at the leu /dollar exchange rate of …………… (Date of the Application form).

Section C: DETAILS ABOUT COMMUNITY AND BENEFICIARIES

1. Number of households and inhabitants in the village/commune.


 Number of households
 Number of inhabitants
 Number of children of schooling age
2. Describe the community access to facilities:

1. Number of households owning private CARS


2. Number of THELEPHONE units in the village
3. Number of households having normal access to SAFE WATER
(wells, taps or supply systems)
4. Number of children of SCHOOLING age spending more than 1 hour
to reach primary school by usual mode of transportation
5. Time taken to reach a medical DOCTOR by usual mode of transport
for the majority of the villagers
6. Number of households having access to ELECTRICITY
7. The village is more than 30 KM of a city and does not have a bus or a
railway connection (Yes/No)
8. Number of TV sets in the village
9. INFANT mortality rate in the village in 1995-1998
10. Number of INHABITANTS OLDER THAN 60 YEARS

3. Describe WHO will benefit from the Project’s output.

Women Men Old people Children

4. Estimate HOW MANY people will benefit from the Project’s output.

Directly (productive group members)


Indirectly:
Employees
Customers
Suppliers
Others, please, indicate….
5. What is the main occupation of the community-based productive group applying for
the grant?
Agricultural workers
Animal breeders
Unemployed people
Other, please specify
6. Is this Project a priority for the community?
YES if yes, How did the community decide it is a priority?
NO

7.Was the community productive group assisted in its Project identification?


YES, If so, by whom? RSDF Facilitator, other person (please, specify)
NO
8. i) Has this application been discussed with the potential beneficiaries of the Project’s
output?

ii) How many meetings have been held?


Number of meetings
When?
How many people attended the meeting(s)?

Attach minutes and attendance lists.


Section C: PROJECT DESCRIPTION

Describe EXACTLY what the community is applying for. (Refer to R-SDF Guidelines
on what the R-SDF does and does not fund). In the case of an application concerning the
completion, upgrading or rehabilitation of an existing economic infrastructure (market,
storage facilities, warehouses, etc) please indicate its existing status. The number of
project objectives and expected results may be larger or smaller than three as indicated
bellow.

1. Project Objectives

1.1.
1.2.
1.3.

2. Expected Project Results


2.1.
2.2.
2.3.

3. Activities to be performed

3.1. Rehabilitation of the Economic Infrastructure

3.2. Manufacturing/Processing

3.3. Training

3.4. Technical Assistance

3.5. Production Marketing


4. Estimate the TIME SPAN and COST of the Project. Use Table 1 in order to
estimate the duration and cost of each activity as well as the total cost and duration
of the project.
Table 1: Project activities

ACTIVITIES* Necessary time span Cost/activity


Weeks, months 000 Lei
1 Rehabilitation of the Economic
Infrastructure
2 Manufacturing/Processing
3 Training
4 Technical Assistance
5 Marketing
TOTAL

* Table 1 contains total costs and duration of the respective activity. Each activity may include other sub-
activities that must be detailed in the standard Table attached at the end of the Application form or in a
similar Table elaborated according to the needs of your community.
The total of the last column of Table 1 represents the total value of the project. Please
remember that the total value of the project equals the grant plus the community
contribution (representing the total 15% of the grant). Other contributions are also
welcomed.

5.Describe any other problems faced by the community and how the outputs of this
Project will assist it in solving it (them).

(Any additional information may be given on separate sheets and attached).

Section D: COMMUNITY -BASED PRODUCTIVE GROUP CONTRIBUTION

The community-based productive group is expected to contribute substantially – at


least 15% of the total grant. Project applications are not considered unless there is
evidence of their contribution. Contributions in cash shall be deposited in the current
account opened by the community.

i) Has the community-based productive group contribution been discussed


with those who will be expected to contribute?
YES
NO
ii) What has the community-based productive group already been done
towards the future Project? What is already collected on site for this
component?

Materials,
Money,
Labor
Other, please, specify ……………

iii) Has the community successfully completed a self - help Project during the
last eight years?

YES, If so, please describe.


NO

iv) Are there any self help projects going on at this time?

YES, If so, when did the project(s) start?


NO

v) Did the community applied for funds concerning the same Project to any
other legal entity?

YES, If so, when and where?


NO

vi) Are there any other possible financing lines for this Project?
YES, If so, mention them.
NO
Section E: IMPLEMENTATION CAPACITY

E 1. PROJECT MANAGEMENT COMMITTEE

In the case of income generating projects the Project Management Committee is


playing the role of the Implementing Agent.

1. General information about Project Management Committee

Name Education Previous experience


Manager
Secretary
Treasurer

2. Address of the PMC Manager


Tel:
3. Date Committee was formed:
Name of Contact Person in Implementing Agency: Address:

Tel:

E 2. OTHER HUMAN RESOURCES

1. What qualified persons do you have available?

2. What special skills or knowledge are needed to manage the Project activities?

Training on Project Management


Training on Bookkeeping and Accountancy
Training on Procurement
Technical Assistance on appropriate technologies

3. Who will provide these skills?


Local Specialists
Business Centers
NGOs
Private firms
Others, please indicate

4. Are there locally available providers of training and technical assistance?


YES
YES, partially
NO
5. Please, give general information about the locally available sub-contractors of
training and technical assistance.

Section F: PROJECT SUSTAINABILITY

1. Who will continue to run the business and to maintain the Project results if it is
completed?

Local Administration
NGOs
Cooperative

2. Has the PMC agreed to manage the further maintenance and operations of the project
as the Operation and Maintenance Committee?
YES, if yes, please provide the list with the members of the Operation and
Maintenance committee and their tasks.
NO

3. If there is no Operation and Maintenance Committee, are there plans to set one up?
YES
NO

Section G: FOLLOWING DOCUMENTS SHOULD BE ATTACHED TO THE


APPLICATION FORM:
• The document that the productive group has become a legal entity according to Law
129/1998
• The Special Mandate of the PMC
• The Business Plan completed according to the standard Form provided by RSDF
• The number of the current account or the application for opening of the current
account addressed to a bank
• Licenses or applications for license for processing raw materials, building, water,
electricity, environment, as the case may be;
• CVs for the members of the PMC, according to the attached standard form
• List with the members of the Operation and Maintenance Committee and their tasks
• Other information and documents supporting the application form.

Section E. FULL NAMES AND SIGNATURES

NAMES SIGNATURES
Manager
Secretary
Treasurer
Number and location of the Current Account
MODEL TABLE FOR THE BUDGET OF THE PROJECT

Activity/Type Total Rehabilitation Manufac Training Technical Marketing


of an Economic and legal
of expenses Infrastructure turing/Pr assistance
ocessing
1 Consultancy
2 Technical
assistance
3 Labor
4 Materials
5 Equipment
/utensils
6 Electricity and
water
7 Fuel
8 Spare parts
9 Utilities
10 Communication

TOTAL
• The total of each column on activities should equal the respective row of the Table1,
Section B of this Application form
• The TOTAL column represents the value of the project
CURRICULUM VITAE

1. PERSONAL DATA:
First name
Last name
Date of birth
Place of birth
Address
Citizenship

2. EDUCATION
(As the case may be)

Other qualifications

3. Last job and the period of time

4. Other skills, hobbies

Date Signature

CONFIRMATION FOR RECEIVAL OF THE APPLICATION PACKAGE

The RSDF confirms the receive of the Application Package from (Name and address
of the Applicant)
The register number of the project ………….

The register number shall be communicated by the RSDF by mail within 10days after
receiving of the Application Package

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