Integrated DevelopmentTown/village(s): District: State: PIN:
3. Project Type (please check all that apply)
4. Please provide the following information about the person who
will serve as the project's director:
Information about additional person(s), if any, who will be
responsible for coordinating the project:
5. Period for which you are requesting funding and its total amount:
Beginning date: D/M/Y Ending date: Amount: Rs.
6. Please describe the current physical, social and economic conditions in
7. If your organization is already working in the project area, please describe its efforts and achievements to date.
8. If, to your knowledge, any development projects similar to the one you are proposing has been carried out within last 10 years, please give the name, its sponsoring organization, its current status, and a brief description of its accomplishments and failures, for each such project.
9. What made you and your organization to undertake the project for which you are now requesting funds?
10. Please describe the objectives of your project and what you want to accomplish during the grant period?
11. What can you do that other development projects in the area, if any, have not done?
12. Please describe the methods, techniques, and approaches you will use to accomplish your objectives?
13. Who and approximately how many will benefit from your project. What specific benefits can they hope to receive?
14. What do you foresee the project to evolve into after the grant period? Will it become self-sufficient ?
Schedule & Progress monitoring
15. To help us understand your project plans, please indicate below the major activities that you hope to undertake during the grant period. Give a brief description of each activity and its plan quarter & year. If you receive a grant from us, we require periodic progress reports and yearly audit report for the project. On-site monitoring may be arranged according to mutual convenience.
Quarter 1: Begin construction of well
Quarter 2: Conduct health camp, get more women & men involved
Quarter 3: Training for new farming technique.
16. If you plan to request funding for more than one year, please indicate the major activities you hope to undertake in year 2 and year 3 (if applicable).
Please note: If this application is accepted, your project will be guaranteed funds for only one year. Funding for additional years will be contingent on your project's performance and our financial resources.
Funding Year 2: From________________ through ____________________
Funding Year 3: From________________ through ____________________
17. List major funding sources for your organization during last 5 years:
Please indicate funding agency's Name , Address & Affiliation where possible.
(Affiliation: Political Party, Social Action Group, Gandhian/Sarvodaya , or Other (explain))
18. If work on this project for which you are requesting fund is underway,
please list below the name and the address of each agency that provided funding and
Name Address Grant Amount Grant Period
19. Does your organization have official Government of India permission to receive foreign funds?
a. If yes, please enclose a copy of the permission form with this application.
b. If no, has your organization applied for this permission?
No. What mechanism do you propose for us to transmit funds to you?
20. Below please provide detailed information on the ways in which you intend to use the funds that you are requesting form us. Please remember that you r project will be evaluated every year for grant of funds after initial
Funding Year 1: __________________ through ___________________
Purpose of Expenditure Expenditure Amount
Total expenditures --- Funding Year 1 Rs._____________
Funding Year 2 (if applicable): __________________ through ___________________
Purpose of Expenditure Expenditure Amount
Total expenditures --- Funding Year 2 Rs._______________
Funding Year 3 (if applicable): __________________ through ___________________
Purpose of Expenditure Expenditure Amount
Total expenditures --- Funding Year 3 Rs._______________
Grand Total --- Funding Years 1-3 Rs._______________
Bibliographies (More About You)
21. With this application form please enclose bibliographical materials on the project director and project coordinators whose names are given on page 1. These materials should include information on the educational qualification and work experience of these individuals, as well as their past activities and accomplishments in
22. Please also submit information on the organization that will be undertaking the project described in this application. This material should explain the organization's basic philosophy and aims and should include a list of its board of directors and their affiliations.
I certify that the information provided in this application is true and complete to the best of my knowledge. I also certify that if I and the organization I am authorized to represent should receive a grant from SEEDS we will abide by the terms and conditions of that grant as established by SEEDS. I further certify that all grant monies from SEEDS will be used exclusively for the purposes stated in this application unless I formally request and receive prior authorization from SEEDS for any changes.
(Signed)_______________________________ Date:_________________________
Social Action
Education
Farming Techniques
Other (specify)
Yes. Date of Application?