DIRECT AID PROGRAM PROJECT APPLICATION FORM APPLICATION NUMBER (For official use only) NOTE: Please read the Application Guidelines carefully before completing this Form. SECTION 1: APPLICANT INFORMATION 1. Name of Applicant 2. Applicant Type If Other, please specify 3. Contact Information Please enter the location and mailing address of your organisation. Physical Address Building Number Street Name Town/ City Postal Code Phone Fax Email Mailing Address (if different from Physical Address) Building Number Street Name Town/ City Postal Code Please provide contact information for the following persons at your organisation: Head of Organisation (Required) Main Project Contact (if different from Head) Name Designation Phone Mobile Email Name Designation Phone Mobile Email 4. Organisation Background Provide background information about your organisation. (Attach brochure or website if available) 5. Staffing Please list the number of staff at your organisation. Full-Time Part-Time Volunteers 6. Previous Funding and Project Implementation Please list the last two (2) projects your organisation has implemented. Dates Project Name and Description Name and Contact of Funding Organisation Amount Funded Comments SECTION 2: PROJECT PROPOSAL 7. Name of project: 8. Recipient Country 9. Project Location (e.g. town/province) 10. Project Description Please provide a detailed description of your project. 11. Total value of Project (in USD) Amount sought (in USD) 12. Project Timeframe Is there a definitive timeframe for the project? YES ☐ NO ☐ If YES, please enter Start and End dates Start Date: End Date: 13. Project Resources Will the applicant be contributing resources to the project? If YES, please describe applicant contribution YES ☐ NO ☐ Are there likely to be recurrent costs associated with the project? YES ☐ NO ☐ DAP funding cannot be used for recurrent costs. If YES, please explain how the applicant will cover recurrent costs Where the project involves training, is the training likely to be utilised after completion of the project? YES ☐ NO ☐ How will this project be identified as sponsored by the Australian Government? SECTION 3: PROJECT ASSESSMENT 14. Have you ever applied for Direct Aid Program funding before? YES ☐ NO ☐ 15. Have you ever been the recipient of a Direct Aid Program grant? YES ☐ NO ☐ If YES, please list details 16. What is the focus of your project? Check as many as apply Poverty alleviation Basic Human Rights Rural Development Assisting women Community level health/sanitation Agriculture/ Food Security ☐ ☐ ☐ ☐ ☐ ☐ Education Environmental conservation Assist disadvantaged/disabled people Training and capacity building Purchase of tools/ equipment Construction 17. Beneficiaries Who are the intended beneficiaries and how will they be selected? How many people will benefit from your project? ☐ ☐ ☐ ☐ ☐ ☐ Men Women Boys Girls TOTAL Will your project involve working with children? (Direct Aid Program considers a child to be a person under the age of 18 years) YES ☐ NO ☐ Do you have child protection guidelines for your project? YES ☐ NO ☐ 18. Monitoring How will the project be monitored throughout the implementation period? 19. Referee Information Please provide details of two Referees for your project. Referee 1 Referee 2 Name Designation Phone Mobile Email Name Designation Phone Mobile Email SECTION 4: REQUIRED DOCUMENTS CHECKLIST 20. Please check documents that accompany your Application. NOTE: Your application will not be processed if all required documentation is not included. You may attach supplemental or supporting documentation, such as background information on the project, sample product or photos (maximum 8 photos). Copy of registration of NGO (for NGOs) ☐ Detailed Project Budget ☐ Financial statement for last financial year (first-time applicants) ☐ APPLICATION GUIDELINES The Direct Aid Program (DAP) is available to individuals, community groups, NGOs and local government agencies engaged in development activities in designated countries on a not-for-profit basis. DAP is primarily aimed at supporting small-scale development projects/activities that are participatory in nature and have involved beneficiaries in their identification, design and management. Projects funded usually range from AUD 5,000 to AUD 30,000. The upper limit for DAP funding is AUD 60,000 per project. Individuals and groups can apply and receive funding for more than one project in a given financial year. Special attention will be given to gender issues, children and other disadvantaged groups. Eligible activities would normally be implemented over a relatively short period of time, generally one year or less. In some cases, two-year projects may be considered. Examples of areas where grants may be given are: community health, education, small scale infrastructure, rural development, capacity building/governance, and the environment. In certain cases, consideration may be given to contributions to disaster relief operations, activities of cultural significance and sporting equipment. As a general rule, the following activities and inputs will not be funded: conferences in-country; Australia or overseas study tours; academic training in Australia; items of a recurrent nature, such as staff salaries, office rental and utility costs, spare parts, supplies, routine maintenance and repairs; payment of consultants and advisors; purchase of major assets or large equipment, e.g. tractors, fridges or photocopiers; and international travel. For further information on the Australian Government’s Direct Aid Program (DAP), please visit the Australian High Commission Website at: http://www.trinidadandtobago.embassy.gov.au/ptsp/cooperation.html Completed forms and additional enquiries can be forwarded to Mr. Clint Fernandez, Senior Policy/ Research Officer at Clint.Fernandez@dfat.gov.au or Ms. Gwendolene Roberts, Policy/ Research Officer at Gwendolene.Roberts@dfat.gov.au, or mailed to: The Australian High Commission P.O. Box 4640 St James Port of Spain Trinidad and Tobago