Contracting Authority:

Central Financing and Contracting Department

Ministry of Finance

 

 

FOSTERING SOCIAL INCLUSION

Grant Application Form

Budget line: IPA- Human Resource Development 04 06 01

Reference: EuropeAid/135-012/M/ACT/MK

To reduce expense and waste, we strongly recommend that you use only paper for your file (no plastic folders or dividers). Please also use double-sided printing if possible

 

Title of the action:  
Number and title of Thematic priority (lot)  
Location(s) of the action: <specify country(ies), region(s), area(s) or town(s) that will benefit from the Action>
Name of the applicant  
Nationality of the applicant[1]  

 

Dossier No  
(for official use only)

 

EuropeAid ID[2]  
Ongoing contract/Legal Entity File Number (if available)[3]  
Legal status[4]  
Co-applicant [5] Name; EuropeAid ID; Nationality and date of establishment; Legal status; Relation with the applicant or co-applicant
Affiliated entity[6] Name; EuropeAid ID; Nationality and date of establishment; Legal status; Relation with the applicant or co-applicant

 

Applicant’s contact details for the purpose of this action
Postal address:  
Telephone number: (fixed and mobile) Country code + city code + number  
Fax number: Country code + city code + number  
Contact person for this action:  
Contact person’s email:  
Address:  
Website of the Organisation:  

 

Any change in the addresses, phone numbers, fax numbers or e-mail, must be notified in writing to the Contracting Authority. The Contracting Authority will not be held responsible in the event that it cannot contact an applicant.

NOTICE

 

When processing your application, any personal data (e.g. names, addresses and CVs), will be recorded and processed if necessary in accordance with national regulation for data protection and Regulation (EC) No 45/2001 on the protection of individuals with regard to the processing of personal data by the Community institutions and bodies and on the free movement of such data. Unless otherwise specified, your replies to the questions and any personal data are required only to evaluate your proposal in accordance with the Guidelines for the call for proposal and will be processed solely for that purpose by the data controller. Details concerning processing of your personal data are available in the privacy statement at http://ec.europa.eu/dataprotectionofficer/privacystatement_publicprocurement_en.pdf

 

The Controller of your call for tender is: Central Financing and Contracting Department (CFCD)

 

Contents

Part A. CONCEPT NOTE.. 5

  1. Instructions for drafting the concept note. 5

1.1.   Summary of the action. 5

1.2.   Description of the action (max 1 page) 6

1.3.   Relevance of the action (max 3 pages) 6

  1. Checklist for the concept note. 8
  2. Declaration by the applicant for the concept note. 10
  3. Assessment grid for the concept note. 11

Part B. Full Application Form… 12

  1. General information. 12
  2. The action. 13

2.1.   Description of the Action. 13

2.2.   Budget, amount requested from the Contracting Authority and other expected sources of funding. 16

2.3.   experiences 16

  1. The applicant 20

3.1.   Identity. 20

3.2.   Profile. 20

3.3.   Capacity to manage and implement actions. 28

  1. The Co-applicant(s) 32

4.1.   Description of the co-applicant(s) 32

4.2.   Mandate (for co-applicant(s)) 33

  1. Affiliated entity(ies) participating in the action. 34

5.1.   Description of the affiliated entity(ies) 34

5.2.   Affiliated entity(ies)’s Statement 36

  1. Associates of the applicant participating in the action. 37
  2. Checklist for the full application form.. 38
  3. Declaration by the applicant 41
  4. Assessment grid for the full application form.. 42

 

 

Part A. CONCEPT NOTE

  1. Instructions for drafting the concept note

Please note that this is a restricted call, only the concept note should be submitted in the first stage (no full application).

 

There is no specific template for the Concept Note but the applicant must ensure that the text:

  • does not exceed 5 full pages (A4 size) of Arial 10 characters with 2 cm margins, single line spacing;
  • provides the information requested under the headings below, in the order in which it is requested, and in proportion to its relative importance (see the relevant scores set out in the evaluation grid and in the Guidelines);
  • provides full information (as the evaluation grid will be applied solely on the information in the concept note);
  • is drafted as clearly as possible to enable it to be evaluated.
    • Summary of the action[7]

Please complete the table below, which should not exceed 1 page.

Title of the action:  
Thematic Priority/Lot:

Please tick the box corresponding to the specific lot for which you are applying:

¨Thematic Priority / Lot 1: Fostering social inclusion of the disadvantaged persons into the labour market

¨Thematic Priority / Lot 2 Integration of minority ethnic communities in the labour market with special focus on women

¨Thematic Priority / Lot 3 Empowering relevant actors in the field of social inclusion

Location(s) of the action: — specify country(ies), region(s) that will benefit from the action  
Total duration of the action (months):  
EU financing requested (amount) < EUR / currency of the Contracting Authority >

 

EU financing requested as a percentage of  total budget of the Action (indicative) %
Objectives of the action <Overall objective(s)>

<Specific objective(s)>

Target group(s)[8]  
Final beneficiaries[9]  
Estimated results  
Main activities  
  • Description of the action (max 1 page)

Please provide all the following information:

Give the background to the preparation of the action.

Explain the objectives of the action given in the table in Section 1.1.

Describe the key stakeholder groups, their attitudes towards the action and any consultations held with them.

Briefly state the type of activities proposed and specify related outputs and results, including a description of linkages/relationships between activity clusters.

State the broad timeframe for the action and describe any specific factor that has been taken into account.

  • Relevance of the action (max 3 pages)
    • Relevance to the objectives/sectors/themes/specific priorities of the call for proposals

Please provide all the following information:

Describe the relevance of the action to the objective(s) and priority (ies) of the call for proposals.

Describe the relevance of the action to any specific subthemes/sectors/areas and any other specific requirements stated in the Guidelines for the call, e.g., local  ownership etc.

Describe which particular expected results referred to in the Guidelines for the call will be addressed.

  • Relevance to the particular needs and constraints of the target country/countries, region(s) and/or relevant sectors (including synergy with other EU initiatives and avoidance of duplication)

Please provide all the following information:

State clearly the specific pre-project situation in the target country/countries, region(s) and/or sectors (include quantified data analysis where possible).

Provide a detailed analysis of the problems to be addressed by the action and how they are interrelated at all levels.

Refer to any significant plans undertaken at national, regional and/or local level relevant to the action and describe how the action will relate to such plans.

Where the action is the continuation of a previous action, clearly indicate how it is intended to build on the activities/results of this previous action; refer to the main conclusions and recommendations of any evaluations carried out.

Where the action is part of a larger programme, clearly explain how it fits or is coordinated with that programme or any other planned project. Specify the potential synergies with other initiatives, in particular by the European Commission.

  • Describe and define the target groups and final beneficiaries, their needs and constraints, and state how the action will address these needs

Please provide all the following information:

Give a description of each of the target groups and final beneficiaries (quantified where possible), including selection criteria.

Identify the needs and constraints of each of the target groups and final beneficiaries.

Demonstrate the relevance of the proposal to the needs and constraints of the target groups and final beneficiaries.

Explain any participatory process ensuring participation by the target groups and final beneficiaries.

  • Particular added-value elements

Indicate any specific added-value elements, e.g. the promotion or consolidation of public-private partnerships, innovation and best practice, or other cross-cutting issues such as environmental issues, promotion of gender equality and equal opportunities, the needs of disabled people, the rights of minorities and the rights of indigenous peoples.

 

 

  1. Checklist for the concept note

EuropeAid/135-012/M/ACT/MK + FOSTERING SOCIAL INCLUSION

+ Budget Line: IPA- Human Resource Development 04 06 01

 

ADMINISTRATIVE DATA To be filled in by the applicant
Name of the Applicant  
EuropeAid ID number  
Nationality[10]/Country and date of registration[11]  
Legal Entity File number[12]  
Legal status[13]  
Co-applicant[14]  
Name of the co-applicant  
EuropeAid ID number  
Nationality/Country and date of registration  
Legal Entity File number  
Legal status  
Affiliated Entity[15]  
Name of the Affiliated-Entity  
EuropeAid ID number  
Nationality/Country and date of registration  
Legal status:  
Specify to which entity you are affiliated (applicant and/or the co-applicant).

Specify the kind of affiliation you have with that entity. 

 

 

 

Before sending your CONCEPT NOTE, please check that each of the criteria BELOW HAVE BEEN MET IN FULL AND TICK THEM OFF

 

Tick the items off below
Title of the Proposal: Yes No
PART 1 (ADMINISTRATIVE)

1.    The Instructions for the Concept Note have been followed.

   
2.    The Declaration by the Applicant has been filled in and signed.    
3.    The proposal is typed and is in English.    
4.    One original and 3 copy(ies) are included.    
5.    An electronic version of the concept note (CD-Rom) is enclosed.    
PART 2 (ELIGIBILITY)

6.    The action will be implemented in  the Beneficiary country.

   
7.    The duration of the action is between 15 months and 24 months (the minimum and maximum allowed).    
8.         The requested contribution is between the minimum and maximum allowed

All lots

·         minimum amount: EUR 61 000

·         maximum amount: EUR 200 000

·           Minimum percentage: 75 % of the total eligible costs of the action.

·           Maximum percentage: 95 % of the total eligible costs of the action

   
9.    This Checklist and the Declaration by the Applicant have been filled in and sent with the Concept Note.    

 

  1. Declaration by the applicant for the concept note

The applicant, represented by the undersigned, being the authorised signatory of the applicant, and in the context of the present application, representing any co-applicant(s), affiliated entity(ies) in the proposed action, hereby declares that:

  • the applicant has the sources of financing and professional competence and qualifications specified in Section 2 of the Guidelines for Applicants;
  • the applicant undertakes to comply with the obligations foreseen in the affiliated entities’ statement of the grant application form and with the principles of good partnership practice;
  • the applicant is directly responsible for the preparation, management and implementation of the action with the co-applicant(s) and affiliated entity(ies), if any, and is not acting as an intermediary;
  • the applicant, the co-applicant(s) and the affiliated entity(ies) are not in any of the situations excluding them from participating in contracts which are listed in Section 2.3.3 of the Practical Guide to contract procedures for EU external actions (available from the following Internet address: http://ec.europa.eu/europeaid/work/procedures/implementation/index_en.htm. Furthermore, it is recognised and accepted that if we participate in spite of being in any of these situations, we may be excluded from other procedures in accordance with Section 2.3.5 of the Practical Guide;
  • the applicant and each co-applicant(s) and affiliated entity(ies) (if any) are in a position to deliver immediately, upon request, the supporting documents stipulated under Section 2.4 of the Guidelines for Applicants.;
  • the applicant and each co-applicant(s) and affiliated entity(ies) (if any) are eligible in accordance with the criteria set out under Sections 2.1.1 and 2.1.2 of the Guidelines for Applicants;
  • if recommended to be awarded a grant, the applicants accepts the contractual conditions as laid down in the Standard Contract annexed to the Guidelines for Applicants (annex G);
  • the applicant, the co-applicant(s) and the affiliated entity(ies) are aware that, for the purposes of safeguarding the financial interests of the European Union, their personal data may be transferred to internal audit services, to the European Court of Auditors, to the Financial Irregularities Panel or to the European Anti-Fraud Office.

Signed on behalf of the applicant

 

Name  
Signature

 

 
Position  
Date  

 

 

 

  1. Assessment grid for the concept note

(FOR THE USE OF THE CONTRACTING AUTHORITY ONLY)

  YES NO
1. The submission deadline has been met.    
2. The Checklist has been duly completed.    
Administrative compliance has been checked by:

Date:

   
DECISION 1: The Committee has decided to evaluate the Concept Note, which has passed the administrative check.    
The Concept Note has been evaluated by:

Date:

   
DECISION 2: The Committee has decided to recommend evaluation of the full application form.    

 

Part B. Full Application Form

only to be completed by applicants who receive an invitation to submit a full proposal (at the time of the invitation)

To reduce expense and waste, we strongly recommend that you use only paper for your file (no plastic folders or dividers). Please also use double-sided printing if possible

  1. General information
Reference of the Call for Proposals Enter EuropeAid reference for the Call for Proposals
Title of the Call for Proposals Fostering Social Inclusion
Name of the applicant  
Number of the proposal[16] Number/not applicable (open procedures)
Title of the action  
Location of the action

specify country(ies) region(s) that will benefit from the action

 
Number of the Thematic priority (Lot)  

 

  1. The action[17]
    • Description of the Action
      • Description (max 13 pages)

Provide a description of the proposed action, including all the information requested below, referring to the overall objective(s) and specific objective(s), outputs and results described in the concept note:

  • Explain the specific results expected, stating how the action will improve the situation of the target groups and final beneficiaries and the technical and management capacities of target groups and/or any local co-applicants and affiliated entity(ies).
  • Identify and describe in detail each activity (or work package) to be undertaken to produce results, justifying the choice of activities and specifying the role of each co-applicant(s) and affiliated entity(ies) (and associates or contractors or sub-grantees where applicable) in the activities. Do not repeat the action plan to be provided in Section 2.2.3, but demonstrate coherence and consistency of project design. In particular, list any publications proposed.
  • Describe/highlight eventual changes of the information provided in the concept note.
    • Methodology (max 5 pages)

Describe in detail:

  • the methods of implementation and rationale for such methodology;
  • where the action continues a previous action, describe how the action is intended to build on the results of the previous action (give the main conclusions and recommendations of any evaluations carried out);
  • where the action is part of a larger programme, explain how it fits or is coordinated with this programme or any other possibly planned project (please specify potential synergies with other initiatives, in particular by the European Union);
  • the procedures for follow up and internal/external evaluation;
  • the role and participation in the action of the various actors and stakeholders (co-applicant(s), affiliated entity(ies), target groups, local authorities, etc.), and the reasons why these roles have been assigned to them;
  • the organisational structure and the team proposed for the implementation of the action (by function: there is no need to include the names of individuals);
  • the main means proposed for the implementation of the action (equipment, materials, and supplies to be acquired or rented);
  • the attitudes of all stakeholders towards the action in general and the activities in particular;
  • the planned activities in order to ensure the visibility of the action and the EU funding.
    • Duration and indicative action plan for implementing the action (max 4 pages)

The duration of the action will be <X> months.

Applicants should not give a specific start-up date for the implementation of the action but simply refer to ‘month 1’, ‘month 2’, etc.

Applicants are recommended to base the estimated duration of each activity and the total period on the most probable duration and not on the shortest possible duration, by taking into consideration all relevant factors that may affect the implementation timetable.

The activities stated in the action plan should match those described in detail in Section 2.2.1. The implementing body must be either the applicants or any of the affiliated entity(ies), associates or subcontractors. Any months or interim periods without activities must be included in the action plan and count toward the calculation of the total estimated duration of the action.

The action plan for the first 12 months of implementation should be sufficiently detailed to give an overview of the preparation and implementation of each activity. The action plan for each of the subsequent years may be more general and should only list the main activities proposed for those years. To this end, it must be divided into six-month periods (NB: A more detailed action plan for each subsequent year must be submitted before any new pre-financing payments are received under Article 2.1 of the General Conditions of the grant contract).

The action plan will be drawn up using the following format:

Year 1
  Half-year 1 Half-year 2  
Activity Month 1 2 3 4 5 6 7 8 9 10 11 12 Implementing body
Example example                       Example
Preparation Activity 1 (title)                         co-applicant and/or  affiliated entity
Execution Activity 1 (title)                         co-applicant and/or  affiliated entity
Preparation Activity 2 (title)                         co-applicant and/or  affiliated entity
Etc.                          

 

For the following years:
Activity Half-year 3 4 5 6 7 8 9 10 Implementing body
Example Example               Example
Execution Activity 1 (title)                 co-applicant and/or  affiliated entity
Execution Activity 2 (title)                 co-applicant and/or  affiliated entity
Preparation Activity 3 (title)                 co-applicant and/or  affiliated entity
Etc.                  
  • Sustainability of the action (max 3 pages)

Provide all the information requested below:

  • Describe the expected impact of the action with quantified data where possible, at technical, economic, social, and policy levels (will it lead to improved legislation, codes of conduct, methods, etc.?).
  • Describe a dissemination plan and the possibilities for replication and extension of the action outcomes (multiplier effects), clearly indicating any intended dissemination channel.
  • Provide a detailed risk analysis and contingency plan. This should include a list of risks associated with each proposed action, accompanied by relevant mitigation measures. A good risk analysis will include a range of risk types including physical, environmental, political, economic and social risks.
  • Describe the main preconditions and assumptions during and after the implementation phase.
  • Explain how the action will be made sustainable after completion. This may include necessary follow-up activities, built-in strategies, ownership, communication plan, etc. Distinguish between four types of sustainability:
  1. Financial sustainability: e.g. financing of follow-up activities, sources of revenue for covering all future operating and maintenance costs.
  2. Institutional sustainability: e.g. structures that would allow the results of the action to continue to be in place after the end of the action, capacity building, agreements and local ‘ownership’ of action outcomes, improved programmes and services which enable sustainable integration of individuals beyond the action duration.
  3. Policy level sustainability: e.g., where applicable, structural impact (improved legislation, consistency with existing frameworks, codes of conduct, or methods).
  4. Environmental sustainability: what impact will the action have on the environment — have conditions been put in place to avoid negative effects on the natural resources on which the action depends and on the broader natural environment?
    • Logical Framework

Please fill in Annex C[18] to the Guidelines for Applicants.

Indicators in the Logical Framework should be quantified in terms of quantity, timing, place and shall be aligned with activities/results elaborated in the Application form.

 

  • Budget, amount requested from the Contracting Authority and other expected sources of funding

Fill in Annex B to the Guidelines for Applicants to provide information on:

  • the budget of the action (worksheet 1), for the total duration of the action and for its first 12 months;
  • justification of the budget (worksheet 2), for the total duration of the action, and
  • amount requested from the Contracting Authority and other expected sources of funding for the action for the total duration (worksheet 3).

For further information, see the Guidelines for Grant Applicants (Sections 1.3, 2.1.4 and 2.2.5) and section 2.3.2 Budget of the Guidelines for Grants within Human Resources Development Component of the Instrument for pre-accession Assistance available at http://cfcd.finance.gov.mk/content/resources/sites/CFCD/misceleniousFiles/Guidelines_for_Grants.pdf.

Please note that the cost of the action and the contribution requested from the Contracting Authority must be stated in EURO.

  • Experiences
    • Applicant’s experience

This information will be used to assess whether you have sufficient and stable experience of managing actions in the same sector and of a comparable scale to the one for which a grant is being requested.

  1. i) For similar actions.

Please provide a detailed description of actions in the same sector and of a comparable scale to the one for which a grant is being requested managed by your organisation in the past three years.

Maximum 1 page per action.

 

Name of the applicant:
Project title: Sector (see Section 3.2.2 of Section 3):
Location of the action Cost of the action (EUR) Role in the action: Coordinator, co-applicant, affiliated entity Donors to the action (name)[19] Amount contributed (by donor) Dates (from dd/mm/yyyy to dd/mm/yyyy)
           
Objectives and results of the action  
   

 

  1. ii) Other actions

Please provide a detailed description of other actions managed by your organisation in the past three years.

Maximum 1 page per action and maximum 10 actions.

 

Name of the applicant:
Project title: Sector (see Section 3.2.2 of Section 3):
Location of the action Cost of the action (EUR) Role in the action: Coordinator, co-applicant, affiliated entity Donors to the action (name)[20] Amount contributed (by donor) Dates (from dd/mm/yyyy to dd/mm/yyyy)
           
Objectives and results of the action  
   
  • Co-applicant(s)’s experience (if applicable)

This information will be used to assess whether you have sufficient and stable experience of managing actions in the same sector and of a comparable scale to the one for which a grant is being requested.

  1. i) For similar actions

Please provide a detailed description of actions in the same sector and of a comparable scale to the one for which a grant is being requested managed by your organisation in the past three years.

Maximum 1 page per action.

 

Name of the co-applicant:
Project title: Sector (see Section 3.2.2 of Section 3):
Location of the action Cost of the action (EUR) Role in the action: Coordinator, co-applicant, affiliated entity Donors to the action (name)[21] Amount contributed (by donor) Dates (from dd/mm/yyyy to dd/mm/yyyy)
           
Objectives and results of the action  
   

 

  1. ii) Other actions

Please provide a detailed description of other actions managed by your organisation in the past three years.

Maximum 1 page per action and maximum 10 actions.

 

Name of the co-applicant:
Project title: Sector (see Section 3.2.2 of Section 3):
Location of the action Cost of the action (EUR) Role in the action: Coordinator, co-applicant, affiliated entity Donors to the action (name)[22] Amount contributed (by donor) Dates (from dd/mm/yyyy to dd/mm/yyyy)
           
Objectives and results of the action  
   

 

  • Affiliated entity(ies) experience (if applicable)

This information will be used to assess whether you have sufficient and stable experience of managing actions in the same sector and of a comparable scale to the one for which a grant is being requested.

  1. i) For similar actions

Please provide a detailed description of actions in the same sector and of a comparable scale to the one for which a grant is being requested managed by your organisation in the past three years.

Maximum 1 page per action.

 

Name of the affiliated entity:
Project title: Sector (see Section 3.2.2 of Section 3):
Location of the action Cost of the action (EUR) Role in the action: Coordinator, co-applicant, affiliated entity Donors to the action (name)[23] Amount contributed (by donor) Dates (from dd/mm/yyyy to dd/mm/yyyy)
           
Objectives and results of the action  
   
  1. ii) Other actions

Please provide a detailed description of other actions managed by your organisation in the past three years.

Maximum 1 page per action and maximum 10 actions

 

Name of the co-applicant:
Project title: Sector (see Section 3.2.2 of Section 3):
Location of the action Cost of the action (EUR) Role in the action: Coordinator, co-applicant, affiliated entity Donors to the action (name)[24] Amount contributed (by donor) Dates (from dd/mm/yyyy to dd/mm/yyyy)
           
Objectives and results of the action  
   

 

 

  1. The applicant

 

EuropeAid ID number[25]  
Name of the organisation

 

 
  • Identity

 

The applicant’s contact details for the purpose of this action  
Legal Entity File number[26]  
Abbreviation

 

 
Registration number (or equivalent)  
Date of registration  
Place of registration  
Official address of registration  
Country of registration  
Website and E-mail address of the organisation  
Telephone number: Country code + city code + number  
Fax number: Country code + city code + number  

The Contracting Authority must be notified of any change in addresses, phone numbers, fax numbers and e-mail, in particular. The Contracting Authority will not be held responsible in the event that it cannot contact an applicant.

  • Profile
Legal status  
Profit-Making □ Yes

□ No

NGO □ Yes

□ No

Value based[27] □ Political

□ Religious

□ Humanistic

□ Neutral

Is your organisation linked with another entity? Yes, parent entity:
(please specify its EuropeAid ID:…………………………)

Yes, controlled entity(ies)

Yes, family organisation / network entity[28]

No, independent

  • Category

 

Category[29] Public

Public Administration

Decentralised representatives of

Sovereign States

International Organisation

Judicial Institution

Local Authority

Implementation Agency

University/Education

Research Institute

Think Tank

Foundation

Association

Media

Network/Federation

Professional and/or Industrial

Organisation

Trade Union

Cultural Organisation

Commercial Organisation

Private

 

 Implementation Agency

 University/Education

 Research Institute

 Think Tank

 Foundation

 Association

 Media

 Network/Federation

 Professional and/or Industrial

Organisation

 Trade Union

 Cultural Organisation

 Commercial Organisation

 Other Non-State Actor

 

 

11     Education
  111     Education, level unspecified
    11110     Education Policy & Admin. Management
    11120     Education Facilities And Training
    11130     Teacher Training
    11182     Educational Research
  112     Basic education
    11220     Primary Education
    11230     Basic life skills for youth and adults
    11240     Early childhood education
  113     Secondary education
    11320     Secondary education
    11330     Vocational Training
  114     Post-secondary education
    11420     Higher Education
    11430     Advanced Tech. & Managerial Training
12     Health
  121     Health, general
    12110     Health Policy & Admin. Management
    12181     Medical education/training
    12182     Medical Research
    12191     Medical Services
  122     Basic health
    12220     Basic Health Care
    12230     Basic Health Infrastructure
    12240     Basic Nutrition
    12250     Infectious Disease Control
    12261     Health Education
    12281     Health Personnel Development
13     Population programmes
  130     Population polices/programmes and reproductive health
    13010     Population Policy And Admin. Mgmt
    13020     Reproductive Health Care
    13030     Family planning
    13040     Std Control Including HIV/Aids
    13081     Personnel development for population & reproductive health
14     Water Supply and Sanitation
  140     Water supply and sanitation
    14010     Water Resources Policy/Admin. Mgmt
    14015     Water Resources Protection
    14020     Water supply & sanitation — Large systems
    14030     Basic drinking water supply & basic sanitation
    14040     River Development
    14050     Waste Management/Disposal
    14081     Education & training in water supply and sanitation
15     Government and Civil Society
  151     Government and civil society, general
    15110     Economic and development policy/planning
    15120     Public sector financial management
    15130     Legal and judicial development
    15140     Government administration
    15150     Strengthening civil society
    15161     Elections
    15162     Human Rights
    15163     Free Flow Of Information
    15164     Women’s equality organisations and institutions
  152     Conflict prevention an resolution, peace and security
    15210     Security system management and reform
    15220     Civilian peace-building, conflict prevention and resolution
    15230     Post-conflict peace-building (UN)
    15240     Reintegration and SALW control
    15250     Land mine clearance
    15261     Child soldiers (prevention and demobilisation)
16     Other Social Infrastructure and Service
    16010     Social/welfare services
    16020     Employment policy and admin. mgmt.
    16030     Housing policy and admin. management
    16040     Low-cost housing
    16050     Multisector aid for basic social services
    16061     Culture and recreation
    16062     Statistical capacity building
    16063     Narcotics control
    16064     Social mitigation of HIV/AIDS
21     Transport and Storage
  210     Transport and storage
    21010     Transport Policy & Admin. Management
    21020     Road Transport
    21030     Rail Transport
    21040     Water Transport
    21050     Air Transport
    21061     Storage
    21081     Education & Training In Transport & Storage
22     Communications
  220     Communications
    22010     Communications Policy & Admin. Mgmt
    22020     Telecommunications
    22030     Radio/Television/Print Media
    22040     Information and communication technology (ICT)
23     Energy
  230     Energy generation and supply
    23010     Energy Policy And Admin. Management
    23020     Power Generation/Non-Renewable Sources
    23030     Power Generation/Renewable Sources
    23040     Electrical Transmission/Distribution
    23050     Gas distribution
    23061     Oil-Fired Power Plants
    23062     Gas-Fired Power Plants
    23063     Coal-Fired Power Plants
    23064     Nuclear Power Plants
    23065     Hydro-electric Power Plants
    23066     Geothermal energy
    23067     Solar energy
    23068     Wind power
    23069     Ocean power
    23070     Biomass
    23081     Energy education/training
    23082     Energy research
24     Banking and Financial Services
  240     Banking and financial services
    24010     Financial Policy & Admin. Management
    24020     Monetary institutions
    24030     Formal Sector Financial Institutions
    24040     Informal/Semi-Formal Financial intermediaries
    24081     Education/training in banking & fin. services
25     Business and Other Services
  250     Business and other services
    25010     Business support services and institutions
    25020     Privatisation
31     Agriculture, Forestry and Fishing
  311     Agriculture
    31110     Agricultural Policy And Admin. Mgmt
    31120     Agricultural development
    31130     Agricultural Land Resources
    31140     Agricultural Water Resources
    31150     Agricultural inputs
    31161     Food Crop Production
    31162     Industrial Crops/Export Crops
    31163     Livestock
    31164     Agrarian reform
    31165     Agricultural alternative development
    31166     Agricultural extension
    31181     Agricultural Education/Training
    31182     Agricultural Research
    31191     Agricultural services
    31192     Plant and post-harvest protection and pest control
    31193     Agricultural financial services
    31194     Agricultural cooperatives
    31195     Livestock/Veterinary Services
  312     Forestry
    31210     Forestry Policy & Admin. Management
    31220     Forestry development
    31261     Fuel wood/charcoal
    31281     Forestry education/training
    31282     Forestry research
    31291     Forestry services
  313     Fishing
    31310     Fishing Policy And Admin. Management
    31320     Fishery development
    31381     Fishery education/training
    31382     Fishery research
    31391     Fishery services
32     Industry, Mining and Construction
  321     Industry
    32110     Industrial Policy And Admin. Mgmt
    32120     Industrial development
    32130     Small and medium-sized enterprises (SME) development
    32140     Cottage industries and handicraft
    32161     Agro-Industries
    32162     Forest industries
    32163     Textiles — leather & substitutes
    32164     Chemicals
    32165     Fertiliser plants
    32166     Cement/lime/plaster
    32167     Energy manufacturing
    32168     Pharmaceutical production
    32169     Basic metal industries
    32170     Non-ferrous metal industries
    32171     Engineering
    32172     Transport equipment industry
    32182     Technological research and development
  322     Mineral resources and mining
    32210     Mineral/Mining Policy & Admin. Mgmt
    32220     Mineral Prospection And Exploration
    32261     Coal
    32262     Oil and gas
    32263     Ferrous metals
    32264     Non-ferrous metals
    32265     Precious metals/materials
    32266     Industrial minerals
    32267     Fertiliser minerals
    32268     Offshore minerals
  323     Construction
    32310     Construction Policy And Admin. Mgmt
33     Trade and Tourism
  331     Trade policy and regulation
    33110     Trade Policy And Admin. Management
    33120     Trade facilitation
    33130     Regional trade agreements (RTAs)
    33140     Multilateral trade negotiation
    33181     Trade education & training
  332     Tourism
    33210     Tourism Policy And Admin. Management
41     General Environment Protection
  410     General environmental protection
    41010     Environmental Policy And Admin. Mgmt
    41020     Biosphere protection
    41030     Bio-diversity
    41040     Site Preservation
    41050     Flood Prevention/Control
    41081     Environmental education/training
    41082     Environmental research
43     Other multisector
  430     Other multisector
    43010     Multisector Aid
    43030     Urban Development And Management
    43040     Rural Development
    43050     Non-agricultural alternative development
    43081     Multisector education/training
    43082     Research/scientific institutions
51     General budget support
  510     General budget support
    51010     General budget support
52     Development food aid/food security
  520     Development food aid/food security assistance
    52010     Food Aid / Food Security Programmes
53     Other commodity assistance
  530     Other commodity assistance
    53030     Import support (capital goods)
    53040     Import support (commodities)
60     Action relating to debt
  600     Action relating to debt
    60010     Action relating to debt
    60020     Debt forgiveness
    60030     Relief of multilateral debt
    60040     Rescheduling and refinancing
    60061     Debt for development swap
    60062     Other debt swap
    60063     Debt buy-back
72     Emergency and distress relief
  720     Emergency and distress relief
    72010     Material relief assistance and services
    72040     Emergency food aid
    72050     Relief coordination; protection and support services
73     Reconstruction relief and rehabilitation
  730     Reconstruction relief and rehabilitation
    73010     Reconstruction relief and rehabilitation
74     Disaster prevention and preparedness
  740     Disaster prevention and preparedness
    74010     Disaster prevention and preparedness
91     Administrative costs of donors
  910     Administrative costs of donors
    91010     Administrative Costs
92     Support to NGO
  920     Support to NGO
    92010     Support to national NGOs
    92020     Support to international NGOs
    92030     Support to local and regional NGOs
93     Refugees
  930       Refugees (in donor countries)
    93010     Refugees (in donor countries)
99     Unallocated/unspecified
  998     Unallocated/unspecified
    99810     Sectors Not Specified
    99820     Promotion of Development Awareness

 

  • Target group(s)
□ All

□ Child soldiers

□ Children (less than 18 years old)

□ Community Based Organisation(s)

□ Consumers

□ Disabled

□ Drug consumers

□ Educational organisations (school, universities)

□ Elderly people

□ Illness affected people (Malaria, Tuberculosis, HIV/AIDS)

□ Indigenous peoples

□ Local authorities

□ Migrants

□ Non-Governmental Organisations

□ Prisoners

□ Professional category

□ Refugees and displaced

□ Research organisations/Researchers

□ SME/SMI

□ Students

□ Urban slum dwellers

□ Victims of conflicts/disasters

□ Women

□ Young people

□ Other (please specify): ……………………………..

 

  • Capacity to manage and implement actions
    • Experience by sector
Sector Year(s) of Experience Experience in the past 7 years Number of Projects in the past 7 years Estimated amount

(in thousand euros) in the past 7 years

  □ Less than 1

□ 1 to 3 years

□ 4 to 7 years

 

□ 7 years +

□ Less than 1 year

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

 

 

□ 1 to 5

□ 6 to 10

□ 11 to 20

□ 21 to 50

□ 51 to 200

□ 200 to 500

□ 500+

□ Less than 1

□ 1 to 5

□ 5 to 20

□ 20 to 50

□ 50 to 100

□ 100 to 300

□ 300 to 1.000

□ 1000+

□ Unknown

  □ Less than 1

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

□ Less than 1 year

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

 

 

□ 1 to 5

□ 6 to 10

□ 11 to 20

□ 21 to 50

□ 51 to 200

□ 200 to 500

□ 500+

□ Less than 1

□ 1 to 5

□ 5 to 20

□ 20 to 50

□ 50 to 100

□ 100 to 300

□ 300 to 1.000

□ 1000+

□ Unknown

  □ Less than 1

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

□ Less than 1 year

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

 

 

□ 1 to 5

□ 6 to 10

□ 11 to 20

□ 21 to 50

□ 51 to 200

□ 200 to 500

□ 500+

□ Less than 1

□ 1 to 5

□ 5 to 20

□ 20 to 50

□ 50 to 100

□ 100 to 300

□ 300 to 1.000

□ 1000+

□ Unknown

 

  • Experience by geographical area
By geographical area (country or region) Year(s) of experience Number of projects in this geographical area in the past 7 years Estimated amount

(in thousand euros) invested in this geographical area in the past 7 years

Indicative list of regions

–      Europe EU

–      Europe non-EU

–      Eastern Europe

–      Central America

–      South America

–      South-East Asia

–      North-East Asia

–      South Asia

–      Central Asia

–      Mediterranean

–      Gulf Countries

–      Eastern Africa

–      Central Africa

–      Western Africa

–      Southern Africa

–      Indian Ocean

–      Caribbean

–      Pacific

 

 

 

□ Less than 1 year

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

□ 1 to 5

□ 6 to 10

□ 11 to 20

□ 21 to 50

□ 51 to 200

□ 200 to 500

□ 500+

□ Less than 1

□ 1 to 5

□ 5 to 20

□ 20 to 50

□ 50 to 100

□ 100 to 300

□ 300 to 1.000

□ 1000+

□ Unknown

  □ Less than 1 year

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

□ 1 to 5

□ 6 to 10

□ 11 to 20

□ 21 to 50

□ 51 to 200

□ 200 to 500

□ 500+

□ Less than 1

□ 1 to 5

□ 5 to 20

□ 20 to 50

□ 50 to 100

□ 100 to 300

□ 300 to 1.000

□ 1000+

□ Unknown

  □ Less than 1 year

□ 1 to 3 years

□ 4 to 7 years

□ 7 years +

□ 1 to 5

□ 6 to 10

□ 11 to 20

□ 21 to 50

□ 51 to 200

□ 200 to 500

□ 500+

□ Less than 1

□ 1 to 5

□ 5 to 20

□ 20 to 50

□ 50 to 100

□ 100 to 300

□ 300 to 1.000

□ 1000+

□ Unknown

 

 

Cross-reference of experience by sector and by geographical area:

 

Sector(s)

(as selected in 3.2.2)

Geographical area(s) (country or region, as identified previously)
   
   
   
   
   
   

 

  • Resources
  • Financial data

Please provide the following information, if applicable, on the basis of the profit and loss account and balance sheet of your organisation, amounts in thousands euros

 

Year Turnover or equivalent Net earnings or equivalent Total balance sheet Shareholders’ equity or equivalent Medium and long-term debt Short‑term debt (<1 year)
N[31]            
N-1            
N-2            

 

  • Financing Source(s)

Please tick the source(s) of the revenues of your organisation and specify the additional information requested

 

Year Source Percentage (total for a given year must be equal to 100 %) Number of fee-paying members (only for source = Member’s fees)
N □ EU   N/A
N □ Member States’ Public Bodies   N/A
N □ Third Countries’ Public Bodies   N/A
N □ United Nations   N/A
N □ Other International Organisation(s)   N/A
N □ Private Sector   N/A
N □ Membership fees    
N □ Other (please specify): ……………   N/A
N Total 100 % N/A

 

Year Source Percentage (total for a given year must be equal to 100 %) Number of fee-paying members (only for source = Member’s fees)
N — 1 □ EU   N/A
N — 1 □ Member States’ Public Bodies   N/A
N — 1 □ Third Countries’ Public Bodies   N/A
N — 1 □ United Nations   N/A
N — 1 □ Other International Organisation(s)   N/A
N — 1 □ Private Sector   N/A
N — 1 □ Membership fees    
N — 1 □ Other (please specify): …………   N/A
N — 1 Total 100 % N/A
N — 2 □ EU   N/A
N — 2 □ Member States’ Public Bodies   N/A
N — 2 □ Third Countries’ Public Bodies   N/A
N — 2 □ United Nations   N/A
N — 2 □ Other International Organisation(s)   N/A
N — 2 □ Private Sector   N/A
N — 2 □ Membership fees    
N — 2 □ Other (please specify): …………   N/A
N — 2 Total 100 % N/A

 

 

Year Name of approved auditor Period of validity
N   From dd/mm/yyyy to dd/mm/yyyy
N — 1   From dd/mm/yyyy to dd/mm/yyyy
N — 2   From dd/mm/yyyy to dd/mm/yyyy

 

 

 

  • Number of staff (full-time equivalent)

please tick one option for each type of staff

 

Type of staff Paid Unpaid
HQ Staff: recruited and based in Headquarters (located in Developed Country) □ < 10

□ > 10 and < 50

□ > 50 and < 100

□ > 100

□ N/A

□ < 10

□ > 10 and < 50

□ > 50 and < 100

□ > 100

□ N/A

Expat Staff: recruited in Headquarters (located in Developed Country) and based in Developing Country □ < 10

□ > 10 and < 50

□ > 50 and < 100

□ > 100

□ N/A

□ < 10

□ > 10 and < 50

□ > 50 and < 100

□ > 100

□ N/A

Local staff: recruited and based in Developing Country □ < 10

□ > 10 and < 50

□ > 50 and < 100

□ > 100

□ N/A

□ < 10

□ > 10 and < 50

□ > 50 and < 100

□ > 100

□ N/A

  • List of the management board/committee of your organisation
Name Profession Function Country of Nationality On the board since
Mr        
Ms        

 

 

  1. The Co-applicant(s)
    • Description of the co-applicant(s)

This section must be completed for each co-applicant within the meaning of Section 2.1.1 of the Guidelines for Applicants. You must make as many copies of this table as necessary to create entries for each additional co-applicant.

 

  Co-applicant no.1
EuropeAid ID number[32]  
Name of the organisation  
The co-applicant’s contact details for the purpose of this action  
Legal Entity File number[33]  
Abbreviation

 

 
Registration number (or equivalent)  
Date of registration  
Place of registration  
Official address of registration

 

 
Country of registration  
Website and E-mail address of the organisation  
Telephone number: Country code + city code + number  
Fax number: Country code + city code + number  
Legal status                                                      Profit-Making □ Yes □ No.

                                                     NGO                □ Yes □ No.            □ Yes □ No

Value based                                                                                                             □ Political    □ Religious    □ Humanistic    □ Neutral
Is your organisation linked with another entity? Yes, parent entity:
(please specify its EuropeAid ID:…………………………)

Yes, controlled entity(ies)

Yes, family organisation / network entity[34]

No, independent

Other relevant resources  
History of cooperation with the applicant  

Important:     This application form must be accompanied by a signed and dated Mandate from each co-applicant, in accordance with the template provided.

  • Mandate (for co-applicant(s))

The co-applicant(s) authorise the Applicant <indicate the name of the organisation> to submit on their behalf the present application form for applicant and to sign the standard grant contract (Annex A of the Guidelines for Applicants, “grant contract”) with the Central Financing and Contracting Department within the Ministry of Finance (“Contracting Authority”), as well as, to be represented by the Applicant in all matters concerning this grant contract.

I have read and approved the contents of the proposal submitted to the Contracting Authority. I undertake to comply with the principles of good partnership practice.

 

Name:  
Organisation:  
Position:  
Signature:  
Date and place:  

 

 

  1. Affiliated entity(ies) participating in the action
    • Description of the affiliated entity(ies)

This section must be completed for each affiliated entity within the meaning of Section 2.1.2 of the Guidelines for Applicants. You must make as many copies of this table as necessary to create entries for each affiliated entity.

 

  Affiliated entity no.1
EuropeAid ID number[35]  
Full legal name  
Date of Registration  
Place of Registration  
Legal status                                                                Profit-Making □ Yes □ No.

                                                               NGO                 □ Yes □ No

Value based     □ Political    □ Religious    □ Humanistic    □ Neutral
If fulfilling the criteria and conditions to be considered as affiliated entity(ies)[36] pecify to which entity you are affiliated (applicant/co-applicant) detailingthe specific nature of the affiliation(i.e. parent entity,  family organisation / network entity, etc)  and, if any, its EuropeAid ID  
Official address of Registration[37]  
Country of Registration[38]/ Nationality [39]  
Contact person  
Telephone number: country code + city code + number  
Fax number: country code + city code + number  
E-mail address  
Number of employees  
Other relevant resources  
History of cooperation with the applicant/co-applicant  

 

   
   

 

Important:      This application form must be accompanied by a signed and dated affiliated entities’ statement from each affiliated entity, in accordance with the model provided.

 

  • Affiliated entity(ies)’s Statement

To ensure that the action runs smoothly, the Central Financing and Contracting Department  within the Ministry of Finance (Contracting Authority) requires all affiliated entity(ies) to acknowledge the principles of set out below.

  1. All affiliated entity(ies) must have read the guidelines for applicants and application form and understood their role in the action before the application is submitted to the Contracting Authority.
  2. All affiliated entity(ies) must have read the standard grant contract and understood what their respective obligations under the contract will be if the grant is awarded. They authorise the entity to which they are affiliated to sign the contract on their behalf with the Contracting Authority and represent them in all dealings with the Contracting Authority in the context of the action’s implementation.
  3. The affiliated entity(ies) must consult regularly with the entity to which are affiliated whom, in turn, should keep them fully informed of the progress of the action.
  4. All affiliated entity(ies) must receive copies of the reports — narrative and financial — made to the Contracting Authority.
  5. Proposals for substantial changes to the action (e.g. activities, affiliated entity(ies), etc.) should be agreed by the affiliated entity(ies) before being submitted to the Contracting Authority. Where no such agreement can be reached, the applicant must indicate this when submitting changes for approval to the Contracting Authority.

I have read and approved the contents of the proposal submitted to the Contracting Authority. I undertake to comply with the principles of good partnership practice.

 

Name:  
Organisation:  
Position:  
Signature:  
Date and place:  

 

 

  1. Associates of the applicant participating in the action

This section must be completed for each associated organisation within the meaning of Section 2.1.3 of the Guidelines for Applicants. You must make as many copies of this table as necessary to create entries for more associates.

 

  Associate 1
Full legal name  
EuropeAid ID number[40]  
Country of Registration  
Legal status[41]  
Official address  
Contact person  
Telephone number: country code + city code + number  
Fax number: country code + city code + number  
E-mail address  
Number of employees  
Other relevant resources  
Experience of similar actions, in relation to role in the implementation of the proposed action  
History of cooperation with the applicants  
Role and involvement in preparing the proposed action  
Role and involvement in implementing the proposed action  

 

 

 

  1. Checklist for the full application form

EuropeAid/135-012/M/ACT/MK/  fostering social inclusion

+ Budget Line: IPA- Human Resource Development 04 06 01

 

ADMINISTRATIVE DATA To be filled in by the applicant
Name of the Applicant  
EuropeAid ID number  
Country and date of registration[42]  
Legal Entity File number[43]  
Legal status[44]  
Co-applicant[45]

 

 

Name/EuropeAid ID number:

Nationality/Country of registration:

Legal status:

Affiliated entity[46]

 

 

Name/EuropeAid ID number:

Nationality/Country of registration:

Legal status:

 

 

Before sending your proposal, please check that each of the following criteria HAVE BEEN MET IN FULL AND TICK THEM OFF Tick the items off below
Title of the Proposal: <indicate the title> Yes No
PART 1 (ADMINISTRATIVE)

1.    The correct grant application form has been used.

   
2.    The Declaration by the Applicant has been filled in and signed.    
3.    The proposal is typed and is in English. Where more than one language is allowed, the proposal is drafted in the language most commonly used by the target population in the country in which the action takes place.    
4.    One original and 3 copy(ies) are included    
5.    An electronic version of the proposal (CD-Rom) is enclosed    
6.    Each co-applicant has completed and signed the mandate and the mandate is included.    
7.    Each affiliated entity(ies) has completed and signed a  affiliated entity(ies) ‘s statement and the statements are included. Please write ‘Not applicable’ (NA) if you have no  affiliated entity(ies)    
8.    The budget is enclosed, presented in the format requested, and stated in EUR.    
9.    The logical framework has been completed and is enclosed.    
PART 2 (ELIGIBILITY)

10.  The duration of the action is between 15 months and 24 months (the minimum and maximum allowed).

   
11.  The requested contribution is between 61 000 EURO and EURO 200 000 (the minimum and maximum allowed).    
12.  The requested contribution is between 75 % and 95 % of the estimated total eligible costs (minimum and maximum percentage allowed).    
13.  The total amount of financing requested on the basis of simplified cost options does not exceed EUR 60 000 per each applicant.    
14. The requested contribution has not been changed by more than 20 % compared to the amount requested at the concept note stage.    

 

  1. Declaration by the applicant

The applicant, represented by the undersigned, being the authorised signatory of the applicant, in the context of the present call for proposals, representing any co-applicant(s), affiliated entity(ies) in the proposed action, hereby declares that

  • Applicant has the sources of financing specified in Section 2 of the Guidelines for Applicants;
  • the applicant has sufficient financial capacity to carry out the proposed action or work programme;
  • Applicant certifies the legal statues of the applicant, of the co-applicant(s) and of the affiliated entity(ies) as reported in part 3, 4, and 5 of this application;
  • the applicant, the co-applicant(s) and the affiliated entity(ies) have the professional competences and qualifications specified in Section 2 of the Guidelines for Applicants;
  • Applicant undertakes to comply with the obligations foreseen in the affiliated entity(ies)’s statement of the grant application form and with the principles of good partnership practice;
  • the applicant is directly responsible for the preparation, management and implementation of the action with the co-applicant(s) and affiliated entity(ies), if any, and is not acting as an intermediary;
  • the applicant and the co-applicant(s) and the affiliated entity(ies) are not in any of the situations excluding them from participating in contracts which are listed in Section 2.3.3 of the Practical Guide to contract procedures for EU external actions (available from the following Internet address: http://ec.europa.eu/europeaid/work/procedures/implementation/index_en.htm. Furthermore, it is recognised and accepted that if we participate in spite of being in any of these situations, we may be excluded from other procedures in accordance with Section 2.3.5 of the Practical Guide;
  • the applicant and each co-applicant and affiliated entity (if any) is in a position to deliver immediately, upon request, the supporting documents stipulated under Section 2.4 of the Guidelines for Applicants.
  • the applicant and each co-applicant and affiliated entity (if any) are eligible in accordance with the criteria set out under Sections 2.1.1 and 2.1.2 of the Guidelines for Applicants;
  • if recommended to be awarded a grant, the applicant accepts the contractual conditions as laid down in the Standard Contract annexed to the Guidelines for Applicants (annex G);
  • the applicant, the co-applicant(s) and the affiliated entity(ies) are aware that, for the purposes of safeguarding the financial interests of the EU, their personal data may be transferred to internal audit services, to the European Court of Auditors, to the Financial Irregularities Panel or to the European Anti-Fraud Office.

These are the sources and amounts of Union funding received or applied for the action or part of the action or for its functioning during the same financial year as well as any other funding received or applied for the same action

<list source and amount and indicate status (i.e. applied for or awarded)>

The applicant is fully aware of the obligation to inform without delay the Contracting Authority to which this application is submitted if the same application for funding made to other European Commission departments or European Union institutions has been approved by them after the submission of this grant application.

Signed on behalf of the applicant

Name  
Signature  
Position  
Date  

 

  1. Assessment grid for the full application form

(to be used by the contracting authority)

  YES NO
opening &administrative check    
1. The submission deadline has been met.    
2. The checklist for the application form has been duly completed.    
DECISION:

The Committee has decided to evaluate the full application form, which passed the administrative checks.

   
Administrative compliance has been checked by:

Date:

evaluation of the full application form    
decision:

A. The proposal has been provisionally selected as one of the top ranked proposals within the available financial envelope and the Committee has recommended eligibility checking.

   
B. The proposal has been put on the reserve list as one of the top ranked proposals and the Committee has recommended eligibility checking    
The proposal has been evaluated by:

Date:

eligibility verification      
3. The checklist for the application form has been duly completed.      
4. The applicant satisfies the eligibility criteria in section 2.1.1      
5. The co-applicant(s), if any, satisfy the eligibility criteria in section 2.1.1.      
6. The affiliated entity(ies), if any, satisfy the eligibility criteria in section 2.1.3.      
7. The supporting documents listed below were submitted in accordance with the Guidelines (Section 2.4)      
a. The applicants statutes      
b. The statutes or articles of association of the applicants and the affiliated entity(ies)      
c. The applicant’s external audit report (if applicable)      
d. The Legal Entity File (see Annex D to the Guidelines for Applicants) has been duly completed and signed by the applicants and the supporting documents requested have been enclosed.      
e. A Financial Identification Form (see Annex E of the Guidelines for Applicants).      
f. Copy of the applicant’s latest accounts.      
Eligibility has been assessed by:

Date:

 
decision:

The Committee has checked the proposal’s eligibility under the criteria laid down in the Guidelines for Applicants and has selected the proposal for funding.

     

 

[1]    An organisation’s statutes must show that it was established under the national law of the country concerned and that the head office is located in an eligible country. Any organisation established in a different country cannot be considered an eligible local organisation.  See the footnotes to the Guidelines for the call.

[2]    To be inserted if the organisation is registered in PADOR (Potential Applicant Data On-Line Registration). For more information and to register, please visit  http://ec.europa.eu/europeaid/onlineservices/pador.

[3]    If an applicant has already signed a contract with the European Commission and/or has been informed of the Legal Entity File number. If not, write ‘N/A’.

[4]      E.g. non-profit, governmental body, international organisation.

[5]    Use one row for each co-applicant.

[6]    Use one row for each affiliated entity..

[7]  Cover page as per template in page 1 should be attached as well

[8]    “Target groups” are the groups/entities who will be directly benefit from the action at the action purpose level.

[9]    “Final beneficiaries” are those who will benefit from the action in the long term at the level of the society or sector at large.

[10]  For individuals.

[11]  For organisations.

[12]  If the applicant has already signed a contract with the European Commission.

[13]  E.g. non-profit, governmental body, or international organisation.

[14]   Add as many rows as co-applicant(s)

[15]  Add as many rows as affiliated entities

[16]  For restricted procedures only; when the Contracting Authority has evaluated the Concept Note it informs the applicant of the outcome and allocates a proposal number.

[17] The evaluation committee will refer to information provided in the Concept Note as regards objectives and the relevance of the action.

[18] Explanations can be found at the following address: http://ec.europa.eu/europeaid/reports//index_en.pdf.

[19]  If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU Member State.

[20]  If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU Member State.

[21]  If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU Member State.

[22]  If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU Member State.

[23]  If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU Member State.

[24]  If the donor is the European Union or an EU Member State, please specify the EU budget line, EDF or EU Member State.

[25]  This number is available to an organisation which registers its data in PADOR. For more information and to register, please visit http://ec.europa.eu/europeaid/work/onlineservices/pador/index_en.htm. This information does not need to be provided in case of calls where the European Commission is not the Contracting Authority.

[26]  If the applicant has already signed a contract with the European Commission.

[27]  Please choose only one set of values.

[28] E.g. confederation / federation / alliance.

[29]  Please specify (1) the sector to which your organisation belongs, as defined in its statutes (or equivalent document): public (established and/or funded by a public body) OR private (established and/or funded by a private entity); (2) in the appropriate column, the category to which your organisation belongs (one choice only).

[30] Please tick the box for each sector your organisation has been active in the past 7 years. The sectors come from the DAC list set up by the OECD.

[31]  N = previous financial year.

[32] This number is available to an organisation which registers its data in PADOR. For more information and to register, please visit http://ec.europa.eu/work/europeaid/onlineservices/pador/index_en.htm. This information does not need to be provided in case of calls where the European Commission is not the Contracting Authority.

[33] If the coapplicant has already signed a contract with the European Commission.

[35]  This number is available to an organisation which registers its data in PADOR. For more information and to register, please visit http://ec.europa.eu/work/europeaid/onlineservices/pador/index_en.htm. This information does not need to be provided in case of calls where the European Commission is not the Contracting Authority.

[36] As described in point 2.1.2. of the Guidelines.

[37]  If not in one of the countries listed in Section 2.1.1 of the Guidelines, please justify its location.

[38]  For organisations.

[39]  For individuals.

[40]  This number is available to an organisation which registers its data in PADOR. For more information and to register, please visit http://ec.europa.eu/europeaid/work/onlineservices/pador/index_en.htm.

[41]  E.g. non-profit, governmental body, or international organisation.

[42]  For organisations.

[43]  If the applicant has already signed a contract with the European Commission.

[44]  E.g. non-profit, governmental body, or international organisation.

[45] Add as many rows as Co-applicants

[46] Add as many rows as Affiliated entity(ies)

 

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