Account of Ngos Format - DOC by akg31466

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									                            PROPOSAL FORMAT
                  NGO INITIATIVE FOR HIV/AIDS PREVENTION


                                 I. Background Information
1. Country:
2. Name:
3. Address:

4. Email:                                    5. Website:
6. Tel:
7. Fax:
8. Three references (names, organization, contact email address):




9. Legal status: (Briefly describe the legal status of your NGO in the context of local laws
and provide a copy of its registration/incorporation certificate.)




10. Management & organization: (Describe your governance, management and
organization structures. Attach a list of Trustees/Board Members with information on their
background. Also provide information on the number of volunteer and paid workers in your
organization.)




11. Mission and activities: (Describe the mission of your organization, major activities and
your notable achievements.)




12. Funding: (Describe your major sources of funding and whether or not your accounts are
audited annually by independent auditors. Also mention if your organization has received
previous support from ADB and, if so, please list the year, amount and describe for what
purpose.)




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                               II. The Proposed Initiative
13. Description: (Concisely describe the proposed initiative to be supported, its objectives,
outputs and outcomes, how these are to be achieved, and some assessment of its expected
impact in fighting HIV/AIDs.)




14. Plan of Action: (Describe the strategy for implementation of the initiative with time-
frame, major milestones and deliverables. State your institutional capacity to implement the
proposed initiative.)




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15. Monitoring and Evaluation: (For each outcome, describe the targets and indicators to
be used to track and measure these outcomes. Also describe what methods ( e.g.,
interviews, surveys, focus groups, etc.) will be used to monitor outcomes and evaluate
impact of the initiative.)




16. Budget: (Itemize cost items with an explanation for the basis of estimates, and indicate
financing plan and how firm your arrangements are for funds needed over and above the
proposed grant amount. Please use the format provided.)
          Item              Contribution from        Contribution from             Total
                            own organization                 ADB
Professional Fees

Travel

Training and
seminars

Reports

Contingencies

17. Experts to be hired: (If local or expatriate experts are to be hired, describe their main
terms of reference, the selection process, and their names (if experts are already identified).




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18. Reporting and audits: (Outline proposed reports to be made to ADB and how the
accounts are to be maintained and audited.)




                                   III. Representation
19. Name and official position of person submitting application:



20. Remittance Information:

Name of Account Holder:
Bank Name:
Branch Name:
Account No./BAN Code:
Address of Bank:
Country:
Swift Code:

20. Date of application:



Signature:




Attach copies of the following documents:
        a. Certificate of incorporation/registration
        b. Complete initiative proposal
        c. Copy of latest audited accounts
        d. Terms of reference of experts to be hired (if applicable)
        e. Any other document considered relevant




                                                   For Internal Office Use

                                                   Application Number:
                                                   Date Received:


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