Poverty Reduction for Chronically Poor Women(PR-CPW) Project

PILOT PROJECT PROPOSAL

On

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A. GENERAL INFORMATION ON APPLICANT

Name of the Organization:
Address:
Street: city: province:
Phone Number:
Fax Number : / E-mail Address:
Head of the Organization/ Designation:
Contact Person/ Designation:
Phone Number:
E-mail Address:
Type of Organization: (please check one)
NGO (International, Afghanistan)
CBO/VO
Academic institution
Local government
Others (specify)
Status of Registration:
(If You are registered NGO, please indicate the registration number)
Registration No:
*please attach a copy of the Registration Certificate
Year of Establishment:
Purpose of Establishment:
Number of Paid Staff/ Profile: (example:2 administration staff, 10 agriculture technician)
*please attach an “organ gram/ organizational chart” , if available.
Number of Unpaid Staff/ Profile: (example: I honorary member, 10 volunteers)
Information on Financial / Technical Assistance Received to Date: (please specify the agencies that have supported you, e.g. from PRT, international organizations, Government of Japan, etc.)
On- going Activities: ( indicate major on- going activities you are doing now)
Description of the project / Project site / Funder / Budget (USD) / Duration
USD
USD
USD
USD
USD
USD
Major Activities in the Past: (Indicate major activities you have implemented in the Past 3 years, Try to select projects that has relevance with proposal you are submitting)
Description of the project / Project site / Funder / Budget(USD) / Project duration
USD
USD
USD
USD
USD
*Attach another sheet of paper if you need more space.
If you had similar project in the past, please state the challenges/issues.Was it successful/unsuccessful? Why?
Annual Budget size: USD ***,*****
* Please enclose a copy of the balance sheet for the past 3 years, if available.
Annual Audit: (Do you conduct annual audit?)
Yes No
* Please enclose a copy of the last Audit Report, if available.

B. SUMMARY OF THE PROPOSED PROJECT

Project Title:
Sector: (please check all the sectors you would like to cover by your proposed project)
Improvement of livelihood, Literacy, Health promotion, Peace building
Skill Training (ex. Handicraft, Agriculture, ICT etc.), Business training
Micro finance/ Micro credit / Group fund,Provision of markets, Providing information to women
Research and survey,Capacity building of group activities
Others (specify) :
Long term Development Strategies for the proposed project:
Development Objective: (Indicate the objective of your project)
Project Duration: ** months, / From (date-month-YYYY) / To (date-month-YYYY)
Project Location: (Indicate districts and villages you would like to cover by your project, if you have a map attach to show the location)
Number of Beneficiaries from the proposed project:
A. Explain who will benefit from this project.
B. Explain the criteria of the beneficiaries and how the beneficiaries will be identified and selected.
C. Break down of beneficiaries
Direct Beneficiaries / Indirect beneficiaries
Female
Male
Total
Estimated Budget Summary:
Cost / JICA
Contribution / Your
Contribution / Others
(if any) / Total
1. Direct Cost / USD / USD / USD / USD
2. Management Cost / USD / USD / USD / USD
Total / USD / USD / USD / USD

C. DETAILS OF PROPOSED PROJECT

Proposal Summary: ( Give a brief Summary of what this project is intending to do, and provide market research evidence indicating why you think through this project women will be able to improve their living standards)
Background Information:
(a) Background of proposal/ current need:
(specify the reason and explain the current situation of women in the project site which need to be improved by implementing this project)
(b) The major problem in the area:
(c ) Compare the situation of women with national average:
Expected Outputs/Outcomes of Proposed Project:
(a) General outcomes:
(b) Economic outcomes for women: (Specify the reason how women will get more incomes or get economic viable through this project. Please justify the reason based upon the market based information.)
Project Activities:
  1. Describe the activities you are proposing in chronological order.
  2. if you are going to provide trainings, please indicate the curriculum and training materials and the CV of the staff so that we will be able to assess the experience of your trainer,
  3. list the activities using the Annex 2
Activity 1:
Activity 2:
Activity 3:
Activity 4:
Impact: (Indicate kinds of impact (social, economical, cultural) that will bring through implementing this project. If any negative impact is expected indicate as well)
Monitoring and Evaluation: (Indicate how, who and when the project will be supervised, monitored, and evaluated by your organization.)
Risk and Assumptions: (Indicate any risk that might prevent this proposed project)
I, the undersigned, hereby declare that the statement given in the application from is true and correct, and, when necessary, I will provides more information requested by the project, I further understand that this is only an application for support, and that it will be considered only during the current Japanese fiscal year ( April-March cycle). I will have no objectioneven if it is turned down as a result of an evaluation.
Date: (day) ………………….. (Month) ………………. (Year) …………………………….
Name: ………………………………………………………………..
Designation: …………………………………………………………
Signature: ……………………………………………………………