Advancing the rights and inclusion of people with disabilities worldwide

Global Disability Development Fund of Rehabilitation International

Grant ApplicationForm

A – The Applicant
  1. Full name of implementing organisation(s):
Pleaselist all participants if there are more than one implementing organization
  1. Name and title of individual(s) responsible for project:

  1. Full postal address
Both head office and field office, if any:
4. Telephone No:
Fax No:
E-mail address:
5. A brief description of the applicant:
B – The Project
  1. Project title:

  1. Projectlocations:

  1. Project category:
□Capacity building □Social inclusion □Rehabilitation □Rights protection
□Education and employment □Assistive devices □Accessibility □Investigation or data collection
□Research □Others:______
4. Project Summary: (no more than 2000 English words)
4.1 Background
4.2 Purpose and objectives
4.3 Need assessment
4.4 Project activities
4.5 Project management
5. Expected results
Please describe the changes or outcomes it is hoped will result from this project – in the short term (immediately following the project) and in the longer term (over the next one to three year period).
  1. Project duration and primary milestones:
Proposed start time, end times, and time period of important activities(mid-term evaluation, submission of final report/financial statement, etc.
7. Local project partner(s) and its contribution, if any:
  1. Project partners abroad and its contribution, if any:

  1. Total project budget:
Please provide an overall estimated budget for the project
10. Funds requested from theGlobal Disability Development Fund:
  1. Funds to be invested by the applicantor by other donors, if any):

12. Will localgovernment agency or institution/community provide any support to the project? If so, please givedetails.

Attachments:

1. Copy of legal status of applicant

2. Full project proposal

3. Detailed budget for the project

4. Annual report of the applicant (for the previous year)

5.Annual audit report of the applicant (for the previous year)

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