Implemented by: German BACKUP Initiative – Education in Africa Application Form – Consultancy Mode Consultancy Mode Please download the Guidelines here. Funding from the German BACKUP Initiative – Education in Africa (BACKUP Education) is available for activities related to the application or implementation of grants from the Global Partnership for Education (GPE). BACKUP Education aims to strengthen and develop the capacities of partners. You may send a short outline or summary of your proposed activity to backupeducation@giz.de before you complete the application form. We will provide feedback on your proposal and guide you through the application process. Funding through the Consultancy Mode is available for up to €50,000. The Consultancy Mode is designed to support the engagement of national and/or international expert and advisory services in developing and implementing national education strategies. Instructions Please consult the BACKUP Education Guidelines to prepare your application. The guidelines are essential to a successful completion of the application form and include a glossary with the terms and definitions used in this form. They provide advice on activities that are eligible for funding from BACKUP Education and for which mode to apply. Before you submit your application to BACKUP Education, please notify the Local Education Group/Coordinating Agency about the request in order to ensure coordination and transparency. Your application will be considered only if the application form is complete and includes the required supporting documents. Submission Send an electronic version of the application form to backup-education@giz.de: The BACKUP Education team will then contact you regarding further procedures. SECTION 1: RELEVANCE OF THE PROPOSED MEASURE FOR GPE COUNTRY LEVEL PROCESSES 1. Title of the measure: 2. Name of country: 3. Name of applicant organisation/ institution: or regional proposal Website link: 4. Please provide a summary of the main components of the proposed measure (max. 150 words): 5. Expected start date (dd/mm/yy): 6. The proposed measure supports: Expected end date (dd/mm/yy): The preparation of the application for a GPE Grant The implementation and monitoring of a GPE Grant Not applicable 7. Please justify the need for the proposed measure (max. 250 words): 8. The need for the proposed measure has been identified in one or more of the following documents: Latest Joint Sector Review Report Capacity Gaps Assessment Capacity Development Strategy Country Status Report Appraisal report of education plan Minutes of LEG meeting Donor Implementation Progress Report Other: Not applicable Please attach or send web link to the relevant document and indicate here the respective page/chapter: 9. Describe how the proposed measure will contribute to the strengthening of GPE country level processes in your country. In order to answer this question, please provide details of relevant GPE grant(s) (amount in US$ and date/year of (planned) approval, grant period, main activities, etc.). Please explicitly state how your measure will link to the GPE grant(s) in your country. 10. If you are applying for support for a regional activity 1 that will involve more than one country, please specify how the measure will contribute to improving GPE/ education sector processes at the national level. 1 Please consult the BACKUP Education Application Guidelines for more guidance on regional and multi-country activities. Application Form – Consultancy Mode Page 2 of 11 11. BACKUP Education encourages joint-funding with other partners. a. Have other donor partners been contacted to support this measure? Yes No If yes, who and what was the response? If no, why not? b. Has your country or will your country receive funds through the following GPE Grants: GPE Education Plan Development Grant Grant period: GPE Programme Development Grant Grant period: Not applicable Application Form – Consultancy Mode Page 3 of 11 SECTION 2: INFORMATION ON APPLICANT APPLICANT ORGANISATION 12. Type of organisation Government institution (e.g. Ministry of Education) Member organization of the national education coalition of CSOs Regional network of CSOs for education GPE Africa constituency National education coalition of CSOs Other regional player 13. Your organisation/institution has engaged in the following: Country Level Regional/Global Level Preparation of the ESP GPE Board of Directors constituencies Implementation of the current ESP Other GPE groups: Joint Education Sector Reviews Not applicable Meetings of the Local Education Group Please explain your role and contribution: Development of a national education policy Other relevant sector engagement: Not applicable Please explain your role and contribution: 14. Is your organisation a member of the Local Education Group (LEG)? Yes No Not applicable (if regional request) Represented through: 15. Please provide the details of the representative from the coordinating agency: Name: Email: Title: Not applicable (if regional request) CONTACT PERSON FOR APPLICATION 16. Surname First Name 17. Position/title 18. Email address 19. Skype 20. Telephone 21. Full postal address Application Form – Consultancy Mode Page 4 of 11 SECTION 3: PROPOSAL DETAILS PROPOSAL PREPARATION Please note that a transparent communication and consultation on the proposal with key stakeholders is a requirement for the application. 22. Please explain how this proposal was developed and who was involved: 23. Has the application been discussed with the Local Education Group (LEG)? Yes No Not applicable (if regional request) If yes, summarise the feedback. If no, explain why not: IMPLEMENTATION OF MEASURE 24. Technical assistance required from: National consultant International consultant 25. Selection process: Potential candidate for consultancy has been identified BACKUP Education is requested to help identify a consultant(s) 26. Required supporting documents (check if attached): Terms of Reference for the proposed consultancy - Draft is mandatory. Please ensure it includes information that is asked in the work plan CV of potential consultant if already identified for the services Documentation of selection process if potential consultant identified - Subject to review based on GIZ rules and regulations of selection processes Quote of selected potential consultant Other: Application Form – Consultancy Mode Page 5 of 11 SECTION 4: SUSTAINABILITY AND KNOWLEDGE SHARING 27. Please describe how your proposed measure will contribute to national capacity development for na- tional education processes? 28. Does your proposed measure ensure CSO participation and/or strengthening the role of CSO’s in edu- cation sector processes? If so, please explain how. 29. Please describe how you will ensure that the outcomes and outputs of this consultancy will be used or developed further to contribute to a sustainable change (max. 150 words): 30. Please choose one of the following: After completion of this measure no follow-up activities and funding will be required Follow-up activities and funding will be required after completion of this measure The proposal includes fundraising activities 31. Please describe how and with whom you plan to share and disseminate the knowledge and products of this consultancy (max. 150 words): Application Form – Consultancy Mode Page 6 of 11 SECTION 5: RESULTS MATRIX You are now required to prepare your results matrix, work plan and budget. Please use the Guidelines to prepare these tables and provide all information as detailed and complete as possible. You can submit the results matrix, work plan and the budget as Excel files using the templates below. 32. Please identify the outcome and outputs that are directly related to your measure. Please formulate specific, measurable, achievable, realistic and time-bound (SMART) indicators. The results matrix will be used to measure progress and success of the proposed measure if funded by BACKUP Education. There can be more than one outcome depending on your proposal. Please modify the table as needed. Level Indicator(s) of achievement Source of (please indicate measurable targets if applicable) verification Assumptions and Risks Outcome: Output 1: Output 2: Output 3: Add more outputs if needed … 33. You will be required to submit a report evaluating the success of your measure. Please describe how you will monitor and evaluate your measure: Application Form – Consultancy Mode Page 7 of 11 SECTION 6: CROSS-CUTTING ISSUES Find further explanations on the cross-cutting issues and how to identify and describe them in regard to your proposed activities in the Guidelines. You may find the Resource List helpful for this section. 34. Use the table below to identify the extent to which the proposed measure will consider the following cross cutting issues. Cross-cutting issue The proposed measure… a. is entirely directed towards improving this cross-cutting issue in the education sector. This is explained in the outcome of the proposal and reflected in the results matrix. b. aims to achieve a specific output related to this cross-cutting issue measured by specific output indicators . c. considers this cross-cutting issue overall but there is no specific related indicator. d. Not applicable Gender equality Conflict/ crisis sensitivity 35. Depending on your selection in the table above, please explain how the following cross cutting issues will be integrated into the proposed measure: a. Gender equality (max. 150 words): b. Conflict/crisis sensitivity (max 150 words): Application Form – Consultancy Mode Page 8 of 11 SECTION 7: WORKPLAN Please specify all single activities to be undertaken with support of BACKUP Education, list them in chronological order under the respective output. Detailed Terms of Reference (ToR’s) can be accepted in lieu of the work plan. Please ensure ToR’s include relevant information as outlined in the table below. Activity Title and Description Describe each individual activity. Start date - End date dd/mm/yy – dd/mm/yy Output Deliverable(s) Key actors List organisations/affiliated persons that will facilitate implementation of the activity. Responsibility for implementation 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. Application Form – Consultancy Mode Page 9 of 11 SECTION 8: BUDGET Please break down the activities listed in the work plan in all cost items related to their implementation. Please note that rates and contracting are handled by GIZ. In case the consultancy is co-financed by you and/or other parties, please indicate the respective contributions and sources of funding. If you submit the budget in an alternative format, please ensure all information requested is included in the table below. Activity Cost item Unit cost (in EURO)* Amount Total (in EURO)* Own resources (in EURO)* Requested financing from BACKUP Education Other co-financing (in EURO)* Name source of co-financing (in EURO)* 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Total *Exchange rate used / date (dd/mm/yy): Application Form – Consultancy Mode Page 10 of 11 Published by: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH German BACKUP Initiative – Education in Africa Dag-Hammarskjöld-Weg 1-5 65760 Eschborn, Germany Tel. +49 (0) 6196 79 3267 Fax +49 (0) 6196 79 80 3267 backup-education@giz.de www.giz.de/backup-education In cooperation with Swiss Agency for Development and Cooperation (SDC), Federal Department of Foreign Affairs On behalf of Federal Ministry for Economic Cooperation and Development (BMZ) BMZ Bonn Dahlmannstraße 4 53113 Bonn, Germany Tel. +49 (0) 228 99 535 -0 Fax +49 (0) 228 99 535 – 35 00 BMZ Berlin Stresemannstraße 94 10968 Berlin, Germany Tel. +49 (0) 30 18 535 -0 Fax +49 (0) 30 18 535 – 2501 poststelle@bmz.de www.bmz.de November 2015 Application Form – Consultancy Mode Page 11 of 11