Expression of interestForm

Description: (Please mention Title of the baseline)

Closing date for submission of EoIs:

Section A. GeneralInformation
FirstName: / Last Name:
Contact Address:
Country: / Contact Phone: (+AreaCode)
Email address(mandatory):
ApplicantStatus:
(Please tickone) / Private
Individual / PrivateCompany
less than 10staff / PrivateCompany
More than 10staff / Other
PleaseSpecify
If Private company or Other, Who willbe
main Lead for thiscall?
Kindly indicate the source ofinformation
for this EoIcall:
Section B: State Qualifications & Priorexperience
What are your skills and experience in the proposedarea?
(if proposing working as a team, please clearly state the competencies of each team member to be involved in this research, evaluation or baseline survey) (max. 250words)
Pleaseindicate5recentbaselinestudiesyouhaveundertakeninthelast3years,
Explaining what type of services you provided (submit copies aswell).
Organization to which services wereprovided / Value of Programme evaluated inUS$ / Year / Services offered e.g. Baseline, Final Evaluation, Mid-term evaluationetc.
Section C : Methodology to Address the Research/Evaluation/SurveyRequirement
Briefly explain the baseline design you will adopt based on the key questions from the ToRs (Maximum
500 words) (Please make sure that the proposed design addresses the Evaluation Criteria as specified inToR)
Based on the proposed methodology, kindly indicate the estimated no. of days’ planned forPrimary data collection and/or related secondary data from target area mentioned inToR.
Type of Datacollection / No of Days
Required / Responsibility
PI/ enumerators only/both
i) Primary data collection from targetarea
ii) Secondary datacollection
Kindly describe how you will consider Gender and Child participation during theassessment
(250words)
Please indicate in country support required from Save the Children Country Officeto
Deliver the ToR? (150words)
Section D: Proposed Budget/Costs (with budgetjustification)
What is your Institutional support cost: In US$/Perday / What is proposed Total Budget (In US$):
Section E: EoI Submission details:
Please mention the name and contact details of the person submitting the proposal
Name: Email address:

Save the Children Sierra Leone MEAL Standard Operational Procedures; December 2015Page 1