1. HSBC 150th Anniversary Charity Programme

In March 2015, HSBC issued the HSBC Anniversary Banknote to commemorate its 150th anniversary.Net proceeds from the sale, amounting to HK$477 million, of which, HK$100 million, will be donated through The Community Chest of Hong Kong to local charities.

HSBC 150th Anniversary Charity Programme - Allocation Via The Community Chest of Hong Kong

Thisspecial allocationis for project providing direct services in Hong Kong, butcapital or research projects will NOT be considered. Applied projects should not be funded by government or other funding bodies. The costing of each project should not be less than HK$150,000 a year andthe maximum annual budget will be capped at HK$1,500,000.The duration of support will not exceed two years in the second phase. Agencies are expected to have their own sustainability plans on respective projects/services at the end of the phase.For those projects supported in the first phase,continuous fundingmay be considered if the original project has achieved good results and has shown clear demonstration of continuous and strong community needs.

  1. Eligibility

Either member agencies of The Community Chest of Hong Kong (the Chest) or member agencies of The Hong Kong Council of Social Service (the Council)

  1. Application Procedures and Application Form

3.1. Each agency can submit up to a maximum of Two applications

3.2. Please complete one form for one proposed project.

3.3. Project Name - precise, self-explanatory and reflective of the intended purposes.

3.4. Funding Request - Please specify clearly the duration of the proposed Project and the amount sought for each year (Part I).

3.5. Agency should provide the measurable output, outcome and measurement method (Part V), detailed breakdown of the costs and the projected income (if any) of the project (Part VI), and other related information, including track record, sustainability plan and etc. (Part VII).

3.6. The application form has to be signed by the Chairperson or Chief Executive

3.7. If the applicant is not a member agency of the Chest, please submit the following documents together with the application form:

3.7.1. 2016/17 audited accounts; and

3.7.2. 2016/17annual report; and

3.7.3. 2016/17 management letter issued by the auditors

  1. Selection Criteria for Initial Application
  2. Meeting the objectives of this programme

To support initiatives that address the current service needs of Hong Kong, with aims of improving lives and promoting well-being of Hong Kong people, fostering mutual help and capacity building. Priority will be given to initiatives targeting at the disadvantaged.

4.2Practicability

the project is cost-effective; and

the output and outcome measurement are clearly identified.

4.3Project Planning

the overall planning and organisational structure of the project is comprehensive;

the Agency has experience, track record, and resources available for the project;

how the project could be continued and financed after Chest funding is ceased.

  1. Selection Criteria for Continuous Funding Application
  2. Result of Original Project

the actual output well-exceeded the original target;

well-received by the community and has strong community impact.

5.2New Target Identified

any new target client or related target group identified.

6. Project Review and Funding Method

6.1. Agency is required to submit the progress report of the approved project every six months. The Chest will conduct project visits and request for information to monitor the project progress.

6.2. For approved projects, the first six months’ allocation will be paid in advance to the agencies concerned. The remaining funding will be released upon receipt of the halfyearly progress reportand satisfactory progress.All unclaimed funds will be retained by the programme.

7. Deadline of the Application

Please send your application form(s) to the following address and email a softcopy in word format to on or before 31 December 2017:

Unit 1805, 18/F, Harcourt House, 39 Gloucester Road, Hong Kong

Attention: Application for HSBC 150th Anniversary Charity Programme

8. For any enquiries about the application, please contact MsKit Chau on 2599-6138.

Application for HSBC 150th Anniversary Charity Programme–

AllocationVia The Community Chest of Hong Kong

[Please submit BOTHhardcopy and softcopy (in word format) () of the completed form

to the Chest Office on or before31 December 2017]

Agency Name : / (English)
(Chinese)

(Please tick as appropriate)

 Member Agency of The Community Chest of Hong Kong

 Member Agency ofThe Hong Kong Council of Social Service

Current Board of Directors or members of the highest governing body

Please add extra page(s) if needed.

Position / Full English Name
(matched with HKID/Travel document)
(Surname, Given names) / Name in Chinese (matched with HKID/Travel document), where applicable

Application for HSBC 150th Anniversary Charity Programme –

AllocationVia The Community Chest of Hong Kong

[Please submit BOTHhardcopy and softcopy (in word format) () of the completed form

to the Chest Office on or before31 December 2017]

Project Name : / (English)
(Chinese)

Contact Person of this Application:

Name : / (English) / (Chinese)
Post Title :
Tel. : / Fax :
Email:
I. Funding Request
Project Period / Requested Amounts (HK$)
2018/19
2019/20
Total:
II. Service Areas: (Please tick as appropriate)
All Districts / YauTsimMong / Shatin / Tuen Mun
Central & Western / Shamshuipo / Taipo / Yuen Long
Southern / Kowloon City / Northern / Tseung Kwan O
Wanchai / Kwun Tong / Tsuen Wan / Islands
Eastern / Wong Tai Sin / Kwai Tsing
III. Project Objectives:
IV. Overall Project Descriptions :
A. Rationale (e.g. community needs, statistics, etc.)
B. Target Clients (e.g. elderly, CSSA recipients, children in poverty, etc.)
C. Service Approach(e.g. cognitive behavioral approach, narrative therapy, community based, etc.)
D. Service Contents (e.g. counseling, groups, community education, talks, etc.)
V. Proposed Output and Outcome
(Please use a separate page to prepare the proposed output and outcome including number of total users, number of total attendance and measurement methods)
Example (for illustration of the format only) / 2018/19 / 2019/20 / Total
(A) Training Groups
  1. No. of groups
/ 10 / 12 / 22
  1. No. of sessions (1 hr per session)
/ 40 / 48 / 98
  1. No. of participants
/ 80 / 96 / 176
  1. No of attendances
/ 224 / 269 / 493
  1. % of participants have enhanced their communication skill (measured by questionnaire)
/ 80% / 80% / 80%
(B) Casework
  1. No. of cases
/ 10 / 16 / 26
  1. No. of counselling sessions (1 hr per session)
/ 60 / 96 / 156
  1. No. of cases closed
/ 4 / 10 / 14
  1. % of users have reduced stress level (measured by questionnaire)
/ 75% / 75% / 75%
No. of total users (=A3+B1…) / 90 / 112 / 202
No. of total attendance (=A4+B2…) / 284 / 365 / 649
VI. Proposed Budget (Please use a separate page to prepare the yearly and the total budget.)
The budget should include :
Projected income with detailed breakdown and calculations
Projected expenditure with detailed breakdown and calculations
Breakdown and calculations of staff costs by position held
Amount requested from the Chest
(should equal to the amount stated in Part I and match with the proposed output)
Remarks:
The factor of provident fund (PF) should be 5% of the monthly salary.
The ceiling amount of PF should be HK$1,500/month/post (i.e. $1,500/month for 1 ASWO, $750/month for 0.5 ASWO).
The ceiling amount of annual audit fee for the project should be HK5,000.
Staff training expenses and research expenses would NOT be supported.
The percentage of spending on indirect administration of the project should NOT be more than 5% of the total expenses after the deduction of income.
Income and expense of each item should be rounded up to the nearest dollar.
Please provide the qualifications of the professional staff in the budget table.
Example (for illustration of the format only)
2018/19 / 2019/20 / Total
Projected income / HK$ / HK$ / HK$
Workshops (100 participants x $500)
Individual training (300 sessions x $250) / 50,000
75,000 / 50,000
75,000 / 100,000
150,000
Total Income (A) / 125,000 / 125,000 / 250,000
Projected Expenditure
Staff Cost (monthly salary x manpower x 12 + MPF)
2 SWA* ($17,000 x 2 x 12 + $10,200 x 2)
1 CA ($8,500 x 1 x 12 + 5,100)
*SWA – Diploma holder, with 5 years social work experience / 428,400
107,100
535,500 / 428,400
107,100
535,500 / 856,800
214,200
1,071,000
Program Expenses
Promotion & Publicity
- Banners (2 banners per year, @1,500)
- Newsletters (4 issues per year, @20,000)
Seminars (2 seminars per year, @$7,500)
Workshops (5 workshops per year, @$6,000) / 3,000
80,000
15,000
30,000
128,000 / 3,000
80,000
15,000
30,000
128,000 / 6,000
160,000
30,000
60,000
256,000
Miscellaneous
Office Stationery
Sundries / 3,000
2,000 / 3,000
2,000 / 6,000
4,000
Total Expenditure(B) / 668,500 / 668,500 / 1,337,000
Amount requested from the Chest (B-A) / 543,500 / 543,500 / 1,087,000
VII. Other Information
A. Track Recordsof the Proposed Service/ Project (e.g. funding source and amount, project period, service output or number of beneficiaries of existing / past projects)
B. Sustainability Plan
C. Other Supplementary Information
VIII.Confirmation

On behalf of the Executive Board of our Agency, I confirm that all information given in this application form and the attached documents are, to the best of my knowledge, accurate and complete.

(Name: )
(Position: )
(Date: )
Signature / Agency Stamp

(Please submit original signed copy to the Chest)

SPF - Page1/7