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Project Type
This is a new projectThis is an ongoing project

Author of Project

Email Address

Title of Project/Initiative

Project Location

1. Describe the work you want to do and how you got the idea. Mention in what ways your work would/does improve people's lives.

2. Who will be helped by this project?
People living with disabilitiesVictims of the above mentioned natural disasterChildren under 18Orphans or children of single parent householdsWomenThe elderly (Above 65)Ethnic - religious - racial minoritiesEconomically vulnerable people (food insecure)People who are ill or have little access to medical careRefugeesInternally displaced peopleOther

* Please specify the number of direct beneficiaries:

People living with disabilities:

Victims of the above mentioned natural disaster:

Children under 18:

Orphans or children of single parent households:

Women:

The elderly (Above 65):

Ethnic - religious - racial minorities:

Economically vulnerable people (food insecure):

People who are ill or have little access to medical care:

Refugees:

Internally displaced people:

Other:

3. Tell us about the project team (partners, employees, volunteers).

4. Are you able/interested to receive international volunteers for this project? What type of work could volunteers do? What skills are needed? What time of the year is best to receive volunteers?

5. Briefly describe how you will measure or evaluate the results of your work.

6. Project Budget Request: Indicate the currency

Please submit a detailed budget in Excel with this form, indicating the local currency costs and their equivalence in USD.

7. By what date would you need these funds?

8. Please submit 3-10 project photos zipped up to 5 MB (equipment needed, the location, people who will benefit, planning sessions, etc).

Photos Privacy
These photos are publishableThese photos are not publishable, but can be shared with individual donors for fundraising purposes

9. What costs will your local team cover for this project?

10. Do you agree to provide a project report with implementation receipts, some photos of the project (the team, any items, any events, etc), and at least two stories from the beneficiaries?
YesNo