Application Form Details of Network !

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Technical Assistance for
Civil Society Organisations
Regional Office
This project is funded
by the European Union.
Application Form
Support to Regional CSO Networks
Details of Network
! If your organisation has registered for our Regional Conference for Regional CSO Networks in IPA countries, Sarajevo
December 2011, then please just provide information for fields marked with *
Regional Network and designated
person
Name of the regional network*
Base Country
Address, phone, fax, e-mail, etc.
Name and details of contact person (e-mail, phone etc.)*
Legal status of the regional network
If formally registered, date of registration of network
Sector/theme of work
Geographic area of work
Total number of member organisations
Proposal
The proposal should be 2-3 pages long maximum.
Title of the Activity Proposed
(main type of activity for which the application is for –advocacy/policy work/study visit, etc)
Background information
(problem statement, action justification, connection with specific policy)
Lot
(please identify lot number)
TACSO Regional Office • Potoklinica 16 • 71 000 Sarajevo • t: +387 33 532 757 • f: +387 33 532 757 • e-mail: [email protected]
SIPU International AB Sweden • Civil Society Promotion Centre Bosnia and Herzegovina • Human Resources Development Foundation Turkey
Foundation in Support of Local Democracy Poland • Partners Foundation for Local Development Romania
1
Technical Assistance for
Civil Society Organisations
Regional Office
This project is funded
by the European Union.
Objectives
(overall objective, purpose and expected results)
Sustainability of the outcomes and outputs deriving from the supported action
Market distortion plan
(type of pro bono services your network is planning to deliver in return to smaller/rural CSO, when and how)
Action location and duration
Total budget breakdown
Amount requested from TACSO, with detailed costs specifications
TACSO Regional Office • Potoklinica 16 • 71 000 Sarajevo • t: +387 33 532 757 • f: +387 33 532 757 • e-mail: [email protected]
SIPU International AB Sweden • Civil Society Promotion Centre Bosnia and Herzegovina • Human Resources Development Foundation Turkey
Foundation in Support of Local Democracy Poland • Partners Foundation for Local Development Romania
2
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