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LB*ph5. hB*ph.@ @ OJQJOJ QJ oOJQJOJQJOJ QJ oPPOJQJL5.OJQJB*phOJQJB*ph phpB*phaJ.WW8Num7WW8Num9WW8Num13WW8Num16WW8Num29WW8Num42@l}~<LM E F c t u   7 8 M ^ s   - ? _ ` x 7HI#$NO (BC]wx$%EWXzJKLMN45z{""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""P GTimes New Roman5Symbol3&ArialiLiberation SerifTimes New RomanU&Arial Unicode MSArial?4Courier New;WingdingsS&Liberation SansArial?DejaVu Sans?5Courier NewBhk#b#b'0k3tDCheck6tDCheck4tDCheck5vDCheck22vDCheck22vDCheck22vDCheck22tDCheck7tDCheck8tDCheck9vDCheck10vDCheck11vDCheck12vDCheck13vDCheck14vDCheck15vDCheck16vDCheck17vDCheck18vDCheck20vDCheck21՜.+,D՜.+,Oh+'0u PX 7Friends of Sierra Leone Project Funds Application FormJamie1@@@s.@Gt(|333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333M 0CCaolan80 ^< " ,l,,|8T-vN L("`)0X-l",8v"`(d(pb)Friends of Sierra Leone Project Funds Application Form Purpose: The Friends of Sierra Leone (FOSL) Project Committee supports non-governmental organizations providing services that directly benefit the people of Sierra Leone. The maximum grant amount is $3,000 although smaller requests are encouraged. Applications are accepted year-round, although the Projects Committee and the FOSL Board reviews and acts upon applications on a semi-annual basis.To be considered, applicants must complete the FOSL Projects application form accompanied by a detailed proposal addressing the areas listed in these directions and a line item budget. Funding Guidelines: Applications for FOSL funding must include all requested information.Failure to include information may disqualify the proposal from consideration. Incomplete applications may be returned for additional clarification at the discretion of the Projects Committee or FOSL s elected board of directors. FOSL will not fund: Political advocacy, litigation activities, political campaigns, attempts to influence legislation in Sierra Leone, or visa or other immigration requests aimed at individuals. Debt relief for any organization. APPLICANTS MUST SUBMIT: Signed Application Form (See Section III of these instructions) Proposal (See Section IV of these instructions) Detailed Budget Grant Application Form Complete all information and return with all attachments to: FOSL Project Chair: Jim Hanson Projects@fosalone.org (electronic submissions are preferred) Or mail to: Friends of Sierra Leone, Projects Committee PO Box 15875 Washington, DC 20003-0875, USA Date of Application:"Text1"      Total Amount requested from FOSL: $  FORMCHECKBOX  / Le FORMCHECKBOX  check one "Text2"      If Leones are used please provide currency exchange rate provided by a local bank Exchange rate number of leones per US dollar. Bank offering the quote"Text3"       Name of organization requesting support: "Text3"      Executive officers of requesting organization: Please use additional sheets if needed"Text3"     Names and titles of project lead and treasurer. Use additional sheet if needed:"Text3"     Address, both physical and mailing address "Text3"     Telephone, both landline and mobile numbers:Landline: ""      Mobile: ""     E-Mail and website (if any):"Text3"      US Contact (if any), name, address and phone or e-mail address:"Text3"     What is the overall purpose of the organization?"Text3"     Please supply brief outlines of projects undertaken during the past one to three years by your organization. Use additional sheets, if needed:"Text13"      What type of organization do you represent? (Check all that apply):  FORMCHECKBOX  Community Based Association: FORMCHECKBOX  NGO:Registration Number: "Text7"     Registration Number: "Text9"      Year Granted: "Text8"      Year Granted: "Text10"       FORMCHECKBOX  Educational Institution   FORMCHECKBOX  Other (Specify):Registration Number: "Text11"     Are you a membership organization? If so, how many active members do you have? Year Granted: "Text12"      "Text6"     SLANGO Member? Yes:  FORMCHECKBOX  No:  FORMCHECKBOX Are you affiliated with a religious organization? Yes:  FORMCHECKBOX  No:  FORMCHECKBOX If so, please indicate:"Text22"     What was your organization s total annual revenue during the past calendar year? "Text16"     What were the organization s total annual expenses in the past year? "Text17"     If you maintain bank accounts, please list their names? "Text18"     What are your organization s major funding sources? (Membership dues, government, local or international NGOs, and any other)"Text19"     Type of project the funding will support:  FORMCHECKBOX Scholarship/Tuition Assistance  FORMCHECKBOX  Health  FORMCHECKBOX  Relief  FORMCHECKBOX  Water  FORMCHECKBOX  Education  FORMCHECKBOX  HIV/AIDS  FORMCHECKBOX  Agriculture  FORMCHECKBOX Culture  FORMCHECKBOX  Sports  FORMCHECKBOX  Social  FORMCHECKBOX  Youth  FORMCHECKBOX  OtherPlease attach your project s budget. We require a detailed line item budget item, quantity, price per item, sub-totals and grand total) describing all estimated expenditures. Please be as detailed as possible and avoid excessive lumping of items. Attach budget on the back of the application.Name of Project:  "Text14"     Sponsoring Organization: "Text15"     Total Cost of Proposed Project: "Text15"     Amount being requested from FOSL: "Text15"     Total number of individuals who will benefit from this project: "Text15"      FOSL cannot proceed without a signed form.Your signature and that of your fiscal officer are needed. Name of the head of the requesting organization (Please Print): "Text20"     Signature of head of the requesting organization: Name of the financial officer of the requesting organization (Please Print): "Text21"     Signature of the financial officer of the requesting organization: Does anyone on your organizations board of directors or leadership body have any personal or professional relationships with a member of Friends of Sierra Leone? Please circle or check:  FORMCHECKBOX  Yes  FORMCHECKBOX  No If so please detail these relationships, utilize an additional sheet if needed. "Text15"      Proposal The proposal itself must contain the following information: Situation What opportunity, problem, issue, or need does your proposal address? What community will benefit from this project? (Province, Chiefdom and town neighbor if located in a large town or city. When will the proposal be implemented and what is the overall timeframe? Is this project a continuation of a prior project? Please describe: Will there be any charge for those being served by the proposed project? If so please explain. How are the individuals who are benefiting being identified? Please list-qualifying criteria and indicate who will be responsible for selecting participants. Impact of Activities How will the proposed activities benefit the community? Be clear and concise about the impact you expect to have and time frame in which all this will take place. How many people will directly benefit from the proposed project? Please provide breakdowns of all those receiving benefits. Include the total number of direct beneficiaries, the number of men/boys and women/girls, if the proposal is for education projects provide a breakdown by elementary, secondary or university levels. If the proposal is for a population with various needs provide a breakdown based on their needs. What impact, if any, with the proposed project have on the environment? Things to consider: Will the project require the draining of wetlands (swamps), cutting of forest (bush) or impact the quality of rivers or streams? If the project will benefit the environment please detail. Long-term strategies for sustaining this effort The FOSL Project Committee seldom provides on-going support to projects. The acceptance of any funding should be conditioned on the fact that FOSL cannot be relied on as a regular or steady source of outside funding. With this in-mind, how will your organization continue this project without additional FOSL funding? Please be as detailed as possible. Evalua