Dr Mehta Seed Fund Application Form I acknowledge that I have read and understood the SDG 4 Targets and Indicators and the Project Grant Criteria Section 1: Organisation Information: Please fill in the information below.1. National federation or association (NFA):* 2. Year of GWI Affiliation:* MM slash DD slash YYYY 3. Number of members in good standing (i.e. dues fully paid):*4. Name and position of the person submitting this 2024 Dr. Mehta Seed Fund (MSF) project:* 5. Email:* 6. Telephone:*Hidden7. Skype ID:* 7. Project team:Please list three people from your NFA who will be directly involved in carrying out the proposed project. Provide information for each of these people in the box below.**It is very important the we have an accurate email address for each person on your project team**Hidden8. Project team:HiddenStaff / Board / Volunteer Name:Staff / Board / Volunteer Name:* Address*Position*Role in Project*Email*Telephone*HiddenSkype ID*HiddenStaff / Board / Volunteer Name:Staff / Board / Volunteer Name:* Address*Position*Role in Project*Email*Telephone*HiddenSkype ID*HiddenStaff / Board / Volunteer Name:Staff / Board / Volunteer Name:* Address*Position*Role in Project*Email*Telephone*HiddenSkype ID*Section 2: The Project1. Name of the project:* HiddenB. Is this a new component/extension of an existing project please state here?* Yes No 2. Situational analysis and need statement?*(Brief situational analysis and problem statement including what evidence there is for the proposed intervention? Use statistics, survey information, community stories and/ or other sources of data that you have available)3. Main aim or goal (purpose) of the project:*(What is the project aiming to achieve?) 4. Main objectives of the project:*(Objectives should be Specific, Measurable, Actionable, Realistic and Time-Bound - SMART)5. Briefly describe the proposed project and what you will do to address the need stated in item 4 above.*HiddenG. If you are expanding an existing project, what is the main aim of the new component/extension of the existing project?(What is the new component/extension of the project aiming to achieve?)6. Assumptions and risks of the project:*(What external conditions must be met to obtain the expected results? What are the problems you might face before or during the implementation of the project? What can you do to minimise these risks?)7. Where will the proposed project take place?*(Include the name and basic geographic information about the target community)8. What publicity do you intend to give to your project?*(Website, media, social media, GWI channels etc. during the project’s lifecycle)Section 3: Partnership and Stakeholders1. Who will benefit from the project?*(Briefly describe the main target groups with whom you will be working, including the number of people to be reached) 2. Community Engagement – Planning: How was the local community involved in planning the project?*(Describe how you involved women and girls in the community to identify needs and develop the project plan)3. Community Engagement – Implementation: How will you involve the community during implementation of the project?*(Briefly describe how you will involve girls and women, local leaders, men and boys, other organisations, etc. in the implementation)4. Involvement and role of the national federation or association (NFA) and its members:*(How will the NFA and its members be involved in the development, implementation and evaluation of the project? What will their roles be?)5. Who are target partners?*(Indicate NFA partner(s) to be involved in the development, implementation and evaluation of the project? Will there be other partners e.g., other NGOs, consultants, external staff? What will their roles be?) 6. Involvement and role of the external stakeholder:*(How will the stakeholder be involved in the development, implementation and evaluation of the project? What will their roles be?) 7. Continuation of project benefits post funding:*(How will the benefits of the project continue after funding ends?)Section 4: Project TimelineYour project must begin once you receive funding from GWI.1. What is the duration of your project?(Give starting date and the projected finishing date. Please note the MSF project funding covers a maximum period of twelve months and is intended to be project seed money.)Starting Date* MM slash DD slash YYYY Finishing Date* MM slash DD slash YYYY Hidden2. Description of the main strategy/strategies and key activities:Hidden2024HiddenJune2. Description of the main strategy/strategies and key activities: (How will your purpose be achieved? Provide an estimated timeframe with beginning and ending dates, and a brief description of your key activities. If your project includes skills training, include information on who will conduct the training and the length of the training. If your project includes manufacturing or other large-scale income generating activities, include information about your business plan, target market and other key details)2024JuneAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenJulyJulyAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenAugustAugustAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenSeptemberSeptemberAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenOctoberOctoberAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenNovemberNovemberAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenDecemberDecemberAction/Activity/Events*Deadline*Responsibility*Deliverable*Hidden2025HiddenJanuary2025JanuaryAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenFebruaryFebruaryAction/Events*Deadline*Responsibility*Deliverable*HiddenMarchMarchAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenAprilAprilAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenMayMayAction/Activity/Events*Deadline*Responsibility*Deliverable*HiddenJuneJuneAction/Activity/Events*Deadline*Responsibility*Deliverable*Section 5: Measurement and Evaluation1. Anticipated measurable results of project:*(What specific, measurable and time-related results do you expect to achieve, within six months and within twelve months? How will you gauge the project’s success?)2. Replicability and scalability of the project:*(Can the project be replicated in other countries easily? Can it be scaled up in your own country and in other countries?) Yes No Please describe below*3. How can other GWI NFAs be positively exposed to this project idea?*4. Procedures for monitoring the implementation and evaluation of the project:*(How will you monitor the implementation of the initiative and evaluate whether it is successful?)Section 6: Project Budget1. Budget estimates (please note that funding will not be given for professional salaries, gifts or honoraria to staff/NFA members/other beneficiaries of the project or office rental)HiddenBudget Item No.Hidden11. Description of expenditure*Total Amount in local currency*Hidden22. Description of expenditureTotal Amount in local currencyHidden33. Description of expenditureTotal Amount in local currencyHidden44. Description of expenditureTotal Amount in local currencyHidden55. Description of expenditureTotal Amount in local currencyHidden66. Description of expenditureTotal Amount in local currencyHidden77. Description of expenditureTotal Amount in local currencyHidden88. Description of expenditureTotal Amount in local currencyHidden99. Description of expenditureTotal Amount in local currencyHiddenTOTALTOTAL:Total Amount in local currencyTotal expenses in local currency:* Additional sources of funding amounts (e.g. NFA contribution, contributions from partner organisations, grants):* For Office Use:Currency Used: Exchange Rate to CHF: * I understand that funding will not be given for professional salaries, gifts or honoraria to staff/NFA members/other beneficiaries of the project or office rental or as mentioned in the Circular Place/date:* Signature:* Δ
