DATE RECEIVED :
EXECUTIVE OFFICER :
JOURNAL NO. :
FILE NO. :
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The Barents Secretariat – Application Form for the Barents ProgrammeAPPLICATION FOR PROJECT FUNDS
FROM THE BARENTS SECRETARIAT 2004
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The Barents Secretariat – Application Form for the Barents ProgrammeGeneral instructions:
This application form is formulated in such a way as to elicit all relevant information required by the Barents Secretariat in order to evaluate your application. All relevant fields must be completed as accurately as possible.
This application form must be completed in Norwegian or English. The form must be completed electronically and sent to the Barents Secretariat in Kirkenes both as an attachment to e-mail (), and as ordinary mail through the postal service (see address below).
You will receive a written confirmation when your application is received. The application will be handled confidentially.
The decision about the project will be made in the Barents Secretariat’s Board of Directors, which consists of representatives from the three North Norwegian County Council Districts, as well as observers from the Ministry of Foreign Affairs and the Ministry of Local Government and Regional Development.
The application deadlines are 15 March and 15 September.
A supplemental project description may be attached to your application. For additional information, refer to the document “Guidelines and Conditions for Grants from the Barents Secretariat”, which may be found at
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The Barents Secretariat – Application Form for the Barents ProgrammeTHE BARENTS SECRETARIAT
Post Box 276, NO-9915 Kirkenes, Norway
E-mail:
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The Barents Secretariat – Application Form for the Barents Programme1
The Barents Secretariat – Application Form for the Barents Programme1. GENERAL INFORMATION ABOUT APPLICANT/PROJECT
Name of Applicant Organisation/ApplicantProject Manager
Contact person
Address
Postal code and city/town, etc.
Telephone
Telephone, contact person
Telefax
Applicant’s Organisation Number /Business Register No.
Project title (maximum 10 words)
Project title in English
Application sum from the Barents Programme 2004 / NOK*
* All amounts must be stated in Norwegian kroner (NOK)
What competence / qualifications does the Applicant have for executing the project?
2. Joint venture partner/organisation Russia (for Norwegian applicants)
Name of Russian partnerContact person
AddressTelephone
Telefax
3. Joint venture partner/organisation in Norway (for Russian applicants)
Name of Norwegian partnerContact person
Address
Telephone
Telefax
4. Other joint venture partners
Name: / Address (and e-mail address):Give a short description of the joint venture partner’s role in the project.
What competence / qualifications does your Joint Venture partner have for participating in the project?
Copy of Joint Venture Agreement attached.
4. GOALS AND PROJECT DESCRIPTION
Give a short description of the objective of the project (who, what, where, when). Maximum 5 lines.
English summary of the project. Maximum 5 lines.
Give a description of the project’s contents and planned activities. If necessary, additional information may be attached.
Separate project description is attached.
Has the Applicant previously received support from the Barents Programme? If so, when and for which project(s)? Provide the project number (s).
What specific results are anticipated from the project?
5. BUDGET
All amounts must be stated in Norwegian kroner (NOK). If necessary, a separate budget may be attached, provided that all relevant information is included.
Activity / Specification / Total budget divided by year / Applied for from the Barents Programme 2004 / Other sources of funding2004 / 2005 / 2006
Project Management
Travel
Classes / Seminars
Translation / Interpreters
Publications
Transport
Admin. expenses
Other expenses (specify)
Total
Please specify the expenses associated with each activity. A detailed budget may be attached.
Is execution of the project conditional upon support from other sources of funding? Yes No
Comments to the budget.
Separate budget is attached.
6. DURATION OF PROJECT
Project’s starting point (month/year): / Project’s ending point (month/year):Will the project extend beyond one year? No 2 years 3 years
7. OTHER RELEVANT INFORMATION
8. SIGNATURE
Place and date: / SignatureTotal attachments: ______
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The Barents Secretariat – Application Form for the Barents Programme