The Population and Reproductive Health Capacity Building Program Concept Note Application Instructions Concept Note Application Instructions: Please use the Concept Note Application form to complete your application. The concept note should be written in English. Please do not adjust the margins of any pages or tables. Page size should remain 8 ½ x 11 inches. Responses should be single spaced, using font style Calibri in font size 12. The file should be in MS Word Document format. The PRHCBP will support grants between the amounts of US$50,000–US$100,000. Awarded grants will fund projects for the period January 1, 2014 –December 31, 2014. Organizations will need to provide a copy of their certificate of registration and audited financial statements for the last two years. If selected the organization will undergo a financial assessment and additional documentation may be required such as the financial manual. All documents must be in English. Please note that the Bank account number must be in the name of the organization applying for the grant. SECTIONS Page limit for the listed sections Basic Information - Organization information 1 page single-sided - Authorized Signatory - Primary Contact - Primary Contact at the Country Level 1 page single-sided Project Details Budget at-a-glance table 1 page single-sided Other partners table No page limit Project Budget table Total length= 3 pages + Project Budget Project Details: 1. Project Title 2. Goals and Objectives: State in 1-2 sentences what long-term overall goal the project will help to accomplish (not necessarily the expected outcome of the 12 month grant period). List the specific objectives of the project. Objectives should be SMART: Specific, Measurable, Attainable/Achievable, Relevant, and Time bound (achievable within the 12 month grant period). The objectives detailed in the concept note must be outcome objectives (outcome objectives are measureable objectives that focus on improvements to a system, changes in policy, knowledge transfer, and changes in attitudes or behavior). Process objectives (measurable objectives that focus on activities to be completed during the grant period such as participants involved in the project, number of interactions during the project period, and 1 The World Bank The Population and Reproductive Health Capacity Building Program Concept Note Application Instructions number of activities) should NOT be included at this stage. However, if your application is selected to continue to Stage 2, detailed process objectives will be required in the full proposal. 3. Country(s) of Project Implementation and Target Group(s): List the country(s) where the project will be implemented and provide information on group(s) that will be targeted by the project. 4. Expected Results: List specific results anticipated during the 12 months of the project and give details on how the measurements (including a baseline) will be obtained. 5. Value Added: Considering the expected results, what is the overall value added of this project? What makes your project unique from what has been done by your organization or others? Irrespective of this grant, would the project’s work proceed? Why or why not? 6. Innovation and Significance of Partnerships: Preference will be given to proposals that catalyze new and existing partnerships with key players at both country and regional levels (e.g.: other NGOs, government, private companies). All concept notes must clearly articulate how the activity relates or contributes to on-going efforts by other donors and how the project contributes to the country(s) national goals for reproductive health. 7. Local Capacity Building: Preference will be given to concept notes that clearly detail how capacity building (local community, NGO/CSO, government, and/or global) will be achieved with this project. Specify whose capacity will be strengthened and how will they use and maintain this newly developed capacity beyond the 12 month grant period? How will building this capacity contribute to the achievement of desired reproductive health outcomes in the country? 8. Sustainability: What financial resources and partnerships are in place to ensure the continuation of the project after the 12 month grant period? If your organization does not receive funding through the PRHCBP grant, how will your organization support this project? 9. Project Budget Use the templates provided for preparing the budget. These are included in the Concept Note Application Form. No cell should be left blank. If the funding source is not applicable for a particular itemized expense, please enter N/A in the cell. 2 The World Bank The Population and Reproductive Health Capacity Building Program Concept Note Application Instructions Required Attachments At the concept note stage (Stage 1), required attachments include the certificate of registration and financial statements for the past 2 years. Submission of Concept Note Please submit the completed package as an attachment in a single email. Please do not send multiple emails. Please submit completed concept note application package via email: To: prhgrants@worldbank.org, rcortez@worldbank.org Cc: ssaadat@worldbank.org, khoyosbaza@worldbank.org Subject: [name of your organization]/2014 DGF PRHCBP concept note application Submission Checklist Incomplete concept note applications will not be considered. Please ensure that the following attachments are included in your email: Completed concept note application form Proof of registration for the organization Audited financial statements for the last two years 3 The World Bank