If you wish to apply with us for a Small Scale Project, please fill in your application in the following format:

(Page 1)

Application for financial support in implementing a micro-project

1) Applicant institution
Name:
Address:
Telephone:
Fax:
E-mail:

2) Legal form of applicant, year of establishment, number of members

3) Responsible contact persons (Name, address)

1.

2.

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4) Project title
(a) Short description of project (please provide full documentation if possible):

(b) Development-policy objective of the project (if applicable also with a view to tangibly improving women's lives in the area):

(Page 3)

5)
(a) Finance plan enclosed? Yes/No
(b) Is overall finance guaranteed? Yes/No
6)
(a) Amount applied for in INR:
(b) Own funds and possible third-party funds:
(c) Total expenditure of project:
(d) Other contributions by applicant to project implementation (e.g. work, land or buildings):

(e) Probable follow-up costs:
(f) Follow-up costs can be financed by applicant or third party: Yes/No
7) Project has not yet commenced/commenced on __________
8) (a) Project start:
(b) Project end:
9) Have you applied for or received any other public funds for this project? Yes/No
If yes, from which institution and how much?

(1st Signature) Rubber stamp of organization
Name and designation Date:

(2nd Signature)
Name and designation
Place, Date 1. signature 2. signature