Micah Network Emergency Response Proposal Template
Micah Network
Micah Network Emergency Response Proposal Template
When preparing a proposal using this template, you will need to refer to the Micah Network Emergency Response Proposal Guidelines (October 2006 version) as it requires additional details to be provided. Alongside each heading in the template, you will see the clause reference for the corresponding section of the Guidelines.
Section A. Basic Information (maximum one page)
—Emergency Response Proposal Guidelines Part 2A
SP reference number (if any)
The name of the Implementing
Partner requesting funding
Description of the programme (maximum 100 words)
Implementing Partner contact
person details:
Name
Role (Job title)
Address
Tel
Fax
Website
The name and role of the person
approving the application for the
Implementing Partner. This person
must be duly authorised.
The planned start date and
duration of the programme.
The location of the programme area
List the international standards and quality commitments which the Implementing Partner has adopted to guide its practice in relief programmes.
The name(s) of any other implementing partner(s) who will be involved in the programme with the Implementing Partner.
Overall budget of the programme.
The amount that the Implementing Partner is requesting from the Supporting Partner with details of other contributions as set out in the table below.
Activity Year / Period 1 / Period 2 / Period 3
Supporting Partner
Other supporting partners
Local and other income
Total
The date that the proposal was written (or date of latest revision)
Section BInformation about the Disaster (maximum one page)-
—Emergency Response Proposal Guidelines Part 2B
Section CEmergency Response Design (maximum one page)
—Emergency Response Proposal Guidelines Part 2C
Section DProgramme Logframe (maximum one page)
—Emergency Response Proposal Guidelines Part 2D/3
Goal
Purpose
Outputs
Activities
Section E Programme Approach and Justification (maximum one page)
—Emergency Response Proposal Guidelines Part 2E
Section F Programme Management (maximum one page)
—Emergency Response Proposal Guidelines Part 2F
Section G Risk Assessment and Management (maximum one page)
—Emergency Response Proposal Guidelines Part 2G
Section H Budget (maximum two pages)
—Emergency Response Proposal Guidelines Part 4
Expenditure / Items / Unitcosts / No of units / Total / Amount from Supporting Partner / Notes and
explanations
Activity and material costs (Relief inputs)
Personnel and related costs
Transport and logistics costs
Capital costs
Evaluation costs
Field support costs —administration and communications
Head Office support costs (limits may be applied by the Supporting Partner)
Other costs
Total Expenditure
Income / Name other donors/describe sources of income / Amount Requested/Expected / Amount Committed
Supporting Partner
supporting partner 2
supporting partner 3
supporting partner 4
Other donors
In-kind donations
Local contributions
Other (please specify)
Total Income
For any variance that exceeds 10% of the budget and US $ 500 the reasons for the over-or under-spend must be explained.
Section I Bank details (maximum one half page)
—Emergency Response Proposal Guidelines Part 5
Account Name
Account Number
Bank Swift Code/BIC number (if known)
Currency of Bank Account
Name of Bank
Address of Bank
Address of Organisation
E-mail Address of Organisation
Annex: Differing Requirements
Section KThe Local Church(maximum one page)
—Emergency Response Proposal Guidelines Annexure 2a
LocalChurch Mobilisation and Christian Witness:
Church Mobilisation Numbers:
Year / Number1
2
3
Total
Please estimate the number of new churches to be mobilised during
each year of the project and hence the total for the life of the project.
Section LMethod of counting beneficiaries
—Emergency Response Proposal Guidelines Annexure 2b
Method:
Beneficiary Numbers:Please estimate the total number of beneficiaries being served during each year of the project. (Column A)
Of those in A, how many are new to the project each year? (Column B)
Of those in B, how many have alreadybeen reported (since 2007) inother Tearfund supported projects? (Column C)
Hence determine for each year the number of new Tearfund beneficiaries. (Column D = column B – column C) / Project Year / Total being served each year / Number new to project each year / Previously reported elsewhere / New to Tearfund each year
A / B / C / D = B-C
1
2
3
Total
Of the total beneficiaries for all years of the project (total of column B), what percentage are: / Female and over18 years / %
Female and under 18 years / %
Male and over18 years / %
Male and under 18 years / %
Total / 100%
Beneficiaries by Sector:
Please state the number of beneficiaries receiving assistance during the life of the project in each of the sectors in the table. It is recognised that the same person may be receiving benefits in more than one area so could be recorded more than once, and that the totals cannot be aggregated. Local level advocacy will often be connected with support in one of the other sectors. / HIV
Health and Nutrition
Water and Sanitation
Basic Education and Literacy
Vulnerable children
Livelihoods and Shelter
Environmental Sustainability and Disaster Risk Reduction
Local level Advocacy
(Others – please state)
Section MQuality Standards Verification
This form requires partners to briefly outline how the quality standards will be reflected in the project implementation.
The questions in normal font refer to core quality standards and all must be answered.
For emergency projects over £100,000,the CR/Partner should select those questions in italics that are a priority to the project and comment on how the project will apply them. Where an emergency project is for £100,000 or less the questions in italics are optional.
brief responses only:1. Values / How are staff made familiar with the organisation's values, the types of unacceptable conduct (eg . exploitation and abuse of children and vulnerable adults, fraud, bribery) and their disciplinary procedures?
2. Impartiality & Targeting / How are beneficiaries selected? Describe how this is based on need and on the most vulnerable people being reached.
3. Accountability / How are community groups participating in the planning of the project? Are staff openly sharing information about the project's aims and ensuring people can give feedback about its delivery?
4. Sustainability / How is the project being designed to be sustainable or replicable?
5. Advocacy / How is the project being designed to address local or national policy issues relevant to the project objectives?
6. Children / How is the project being designed to prevent an increase in the vulnerability of children?
How is the project being designed to support child development and to protect children from harm?
7. Gender / How is the project being designed to prevent an increase in the vulnerability of women?
How is the project being designed to promote inclusiveness of both men and women, and enhancing the safety of women and girls?
8. HIV / How is the project being designed to prevent an increase in the vulnerability of people to HIV?
How is the project being designed to reduce the likelihood of people becoming more vulnerable to HIV?
9. Environment / How will the project ensure that it is not contributing to environmental degradation?
How is the project being designed to reduce environmental damage and to increase positive environmental outcomes?
10. Disaster Risk / How is the project being designed to build up community capacity and address long-term vulnerability to disasters?
11. Conflict / How is the project being designed to avoid heightening tension or making people more vulnerable to physical harm?
How is the project being designed to promote peace and reconciliation?
12. Technical Standards / How is the project design ensuring that its outputs will be of a good technical standard?
Micah Network Emergency Response Proposal Template (Version date: Oct 2006, Tearfund May 2012) 1.