Community Support and Social Cohesion Funding Programme

/ KAAPSE WYNLAND DISTRIKSMUNISIPALITEIT
CAPE WINELANDS DISTRICT MUNICIPALITY
UMASIPALA WESITHILI SASECAPE WINELANDS

2015/2016

Community Support and Social Cohesion Funding Programme

Application Form

Overview

Thank you for your interest in the Cape Winelands District Municipality’s (CWDM) Community Support and Social Cohesion Funding Programme

The Municipality has established a culture of supporting organisations that contribute to achieving the National, Provincial and District development goals of the country. The program supports community based initiatives and strengthen service delivery in communities. This programme also enables organisations to undertake actions and services to improve the standard of living of the communities, resulting in an improvement in the quality of life of residents.

Community based organisations apply for the Community Support and Social Cohesion Funding Programme on appearance of an advertisement in the local newspapers, on notice boards and on the website of the municipality.The programme is advertised annually and allocations to beneficiary organisations are transferred electronically.

VERIFICATION

Contact Detail

Name of Organisation/School/ Club:
Physical Address / Postal Address
Name of Contact Person Name
Contact Number
Tel no: / Fax No:
Email: NPO Registration number
Total number of members in the group/organisation
Has your organisation submitted an application for the Community Support Programme grant before? / Yes / No
Was your application successful? / Yes / No

2. Purpose of Funding Grant

2.1 State what this grant is for? How do you intend on using the funds?
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Questions / Yes / No / Comments
When was the organisation established?
Does your organisation have a governing body / structure/ executive?
Does your organisation have monitoring and evaluation reporting measures?
Does your organisation have an active bank account?

Is your declaration of interest form attached to this application? YESNO

The undersigned persons acknowledge that the information provided is correct

Please write the names in print.

Name: …………………………………………………………………………………………..

Signature:…………………………………………………………………………………………

Date:…………………………………………………………………………………………………

CWDM OFFICIAL USE
Name of official / Recommendation / Comment
Yes / No
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1DESCRIPTION OF ORGANISATION

1.1Mission of Organization:

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1.2Objectives of Organization:

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1.3Provide a background of the project you wish to acquire funding for (include information about when it started, how it started, who initiated it and why)

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1.4Provide background of the area in which the project will be implemented (including information on what impact the project will have in this area)

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1.5Main activities of project (current/future)

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1.6What is the estimated cost of the project?

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1.7How much funding do you require for the project? Please provide an itemised breakdown )

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2FUNDING MOTIVATION

2.1What community problems/issues will the project address?

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2.2What other projects similar to yours exists in your community/targeted area?

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2.3How is your project different from ones that already exist in your community/targeted area?

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2.4Describe your project’s target group and explain why you have chosen this group.

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2.5How did you identify the target group?

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2.6Describe the impact that your project will have on people in your community/targeted area

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3.7How will you promote your project to people in your community/targeted area?

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3OWNERSHIP

3.1Is the community involved in the project; if so, to what level?

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4SUSTAINABILITY

4.1Who are your partners and how are these partners contributing to the project

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4.2What other funding sources does your project have?

Source of Funding / Year Funded / Amount Funded

5CHECK LIST

5.1Please check if you have the following

Documents Required / Yes / No
Certified copy of your Registration Documents
Project Proposal
Itemised Budget Breakdown
3 Year Financial Projections/Plan
A copy of your Constitution
Policy Documents
Details of Management Committee
Copy of Organisational Structure/Organogram

Application submitted by(Name & Surname) :

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Signature:

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Date of submission:

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