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Canada
The Canada Fund for Local Initiatives
Application Form

This application has five sections, each with a variety of questions. These questions are designed to help us
better understand your organization and your intended project. Answer each question as completely as
possible, you can add more pages if the space is not sufficient. Incomplete answers will delay the
processing of your application. Thank you for your interest in the Canada Fund.

Return completed applications to:

Canada Fund Co-ordinator
P.O.Box 1856
For Office Use Only
Gaborone
Fax: 307098
Date Received: _____________________
Date Reviewed: ____________________
Date: ______________________________________
Site Visit Required: _________________
Date Confirmed: ____________________
Contact person: ______________________________
Action Taken: _________________________
Name and Organisation: _______________________
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Telephone: __________________________________
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Fax: _______________________________________
Address: ___________________________________ O Rejected o Sent to CHC O Approved
Name of Project: _____________________________

TOTAL REQUESTED FROM CANADA FUND _____________________________

I. OVERVIEW

1. Describe your organization. (When was it started, number of members by sex, how often the members
meet, the role of the members, describe any Board or Committee you have, people who sit on it and their
responsibilities, are they appointed or elected, the role of the Committee/Board, how often does the
committee meet).________________________________________________________________
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2. What is your organisation’s mandate? (What type of projects/activities have you done in the past and why,
and what are you doing now). _____________________________________________________
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3. What have been your organisation’s main achievements? ____________________________________

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4. What problems has your organization faced in the past and how have you dealt with them. _________
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5. List any other organizations you are affiliated with. ________________________________________

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6. List any donors you have previously received funding from (including date and amounts if possible).
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7. Describe any previous funding you have received from CIDA and/or Canada Fund (include dates, amount
CIDA/CF and purpose). ________________________________________________________
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8. Does your organization have a bank account? Yes No

If yes… who controls it? ______________________________________________________________
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II. PROJECT DESCRIPTION

1. Describe in detail what your project is and how you intend to spend CFLI funds. _________________
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2. GOAL-What do you expect to achieve with your project? ___________________________________

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3. OBJECTIVES- describe each activity you will need to perform to archive your goal (stated above).
Include the resources (materials, training, etc.) required and each activity necessary to achieve these
objectives_____________________________________________________________________________
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4. RESULTS- Describe what you expect to achieve by performing each of the above stated objectives. How
will people benefit from your project? ____________________________________
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5. Explain why you community needs this project. ____________________________________________

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6. Is there a similar project currently operating in your community? Yes No

If yes…describe all similar projects (what they are doing, who they target, market). _______________
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7. Describe who will participate in the project (Sex, number, staff, trainees, beneficiaries and their roles).
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8. Who or what groups is your project targeting? Describe the impact the project will have on these people?
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9. Highlight any participation by women and people with disabilities in your project.
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10. Describe any negative or positive effects the project will have on the environment.
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11. How does this project satisfy the Canada Fund requirements (see information sheet)?
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III. SUSTAINABILITY

1. Has your project been approved by the local authorities (Chief or Community Council)? Yes No
Please explain: _____________________________________________________________________
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2. Will the project be able to continue after the Canada Fund has finished its contribution? Why or why not?
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3. What activities will the project be performing after utilizing the Canada Fund contribution? ________
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IV. INCOME GENERATING PROJECT ONLY

1 Describe any market research you have performed (who you will sell your product to, demand for the
product, supply from others of the same product, transport of product, selling price, production costs,
salaries, etc).
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2. Please provide estimate of any income the project is expected to produce throughout the life of the
project. If the project is already producing an income, include projected increases based on the new
activity to be performed with CFLI funding. ______________________________________________
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4. Explain how this income will be used. How will the participants of the project benefit from this
income? ___________________________________________________________________________
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V. BUDGET

Please fill out the following budget based on the terms defined below. Be as accurate and detailed as
possible. Incomplete applications will delay the process.

DESCRIPTION OF GOOD OR ACTIVITY-Please list all supplies and /or activities to be performed
throughout the life of the project.

AMOUNT-the cost of particular good or activity

SOURCE:
In-Kind-refers to any activity which is performed where money des not change hands (is. The organization
provides labour or other services).
Organisation- any money the organization has available to contribute to the project.
Other donors-any amount of money secured from other donor sources (please indicate donor).
CFLI-the amount of money requested from Canada Fund.

**IMPORTANT**
Organisation=s Must contribute to the project either financially on in-kind. Pease attach a quote from
suppliers for each particular good or activity which the project is requesting assistance for from
CFLI- the amount of money requested from Canada Fund.

Description of good or activity Amount Source

TOTAL PROJECT COSTS

TOTAL PROVIDED BY PROJECT
TOTAL PROVIDED BY OTHER DONORS

TOTAL REQUESTED FROM CANADA FUND