Name of MSAT: Address of MSAT: Ask for: Cela: Vra vir: Tel: Fax: Umnxeba: Ifeksi: Tel: Faks: E-mail: Webmail: Ref: File name: Letter of Commitment CITY HEALTH Date: To: (Name of project) Attention: (Name of project manager) CONDITIONS FOR FUNDING I ___________________________________________________, on behalf of __________________________________________, hereby accept the conditions which need to be adhered to in order to continue to receive funding. Conditions for funding: 1. Attend all MSAT meetings and participate fully in MSAT activities 2. Compile narrative and financial reports using the correct format 3. Submit reports by the 5 of every month 4. Submit quarterly programmes to the MSAT Co-ordinator (…………………………………………….) timeously in order for th her/him to visit the sites 5. Submit proof of attendance (e.g. photos, attendance registers) for an event to the MSAT Co-ordinator 6. The MSAT Co-ordinator will provide a completed template to the Administrative Officer each quarter indicating whether the conditions have been met. I understand if any of the abovementioned conditions have not been met, my funding will be stopped with immediate effect. Signed at ____________________________ on this day ____________________ March 20….. _________________________ Signature ____________________ _____________________ Subdistrict Manager: Subdistrict Administrative Officer Subdistrict