Thursday, July 7, 2011

SMALL GRANT APPLICATION FORM

                                                                                                                Príloha č. 1  k Smernici č.92/2009  

SMALL GRANT APPLICATION FORM   
The Application Must Be Submitted in English




Name of the project:




Name of the organization (English translation):




Name of the organization (in local language):



Address:



Phone and fax numbers, e-mail address:




Represented by (name, title):





Background of the representative (please state the representative´s title and background and attach CV of the people who will be engaged in the project):





Background of the organization (please attach a copy of the registration papers):






Any previous Slovak Government funding:




Project start date: (month/year)
Project end date: (month/year)
(Note: Max. project contractual period not to be exceed 6 months)




Amount requested (in EURO):







Project description:







Project purpose(what goals will be achieved and how the results will be determined/measured):






Project justification (please describe the need or problems the project will solve and the target groups):






Project sustainability:







Detailed description of the project activities:





Detailed budget (please use the table below):

Budget items:             
Price per unit:
Number of units:
Slovak Embassy budget:
Final Beneficiary cost sharing if applicable:
Other support cost sharing if applicable:
Total in EURO:






































































TOTAL in EURO:












How will you meet the program and financial reporting requirements (e.g., who will prepare the financial report?):





Final Beneficiary cost sharing if applicable, (other support cost sharing if applicable):





Other organizations you applied to with the same project and status of your application:










_________________________                                                         __________________________
City, date                                                                                                         Signature of Applicant











--------------------------------------------------------------------------------------------------------------------------------------
SLOVAK EMBASSY RECORDS ONLY



Application No.
Received (date)
Amount Requested
Amount Awarded







Slovak Embassy recommendation:







                                                                                                                                ___________________________
                                                                                                                                                Head of Mission