APPLICATION FORM WWF-MALAYSIA CONSERVATION PARTNERSHIP SCHEME

Transcription

1 APPLICATION FORM WWF-MALAYSIA CONSERVATION PARTNERSHIP SCHEME The application form should be accompanied by Organization profile. CV of the project leader and team member A short synopsis of a past project Contact Details Organization Name of Project Lead Contact details Address Occupation / Position Project Details Project Title: Telephone Fax Project Period (from DDMMYYYY to DDMMYYYY): Project Location: Thematic Categories: Biodiversity Status Monitoring Greener lifestyle Habitat restoration and/or management Citizen Science Conservation enterprise / Sustainable livelihood Capacity building SUMMARY What is this proposal about? (Not more than 300 words) 1. Background. What issues, problems, threats and/ or opportunities are creating the need for this project? (Not more than 300 words) 2. Objectives. What is this project for? What impacts or outcomes do you plan to achieve, where, by when and/or for whom? Propose 3 objectives for your project. Be specific, measurable, achievable, relevant and time-bound (SMART) in your objectives setting.

2 1. Project workplan. Briefly describe main activities/outputs to be delivered in the project timeline. Advisable to have two to five major activities and one to three measurable indicators 1 for each objective. An example of workplan template is shown below. You can attach your workplan as an appendix. Measurable Indicators 1. E.g.: Objective 1 E.g.: number of tree planted Target Month Month Month Month Month Month E.g.: 200 trees 1.1 Activity 1.2 Activity 2. Objective 1.1 Activity E.g. number of monitoring cycle/month E.g. 2 cycles per month How could the project outcomes achieved sustain after this funding ends? Any follow-up plan after the current project phase ends? 4. Budget. Provide description of budget breakdown for major activities. Major Activities Description of planned expenditure Subtotal (RM) E.g. Training on hatchery management for 20 pax (this should correspond with the workplan) Meeting package = 20 pax x RM30/day x 2 days = RM1,200 Training materials = RM200 Memento for trainers = RM50 x 3 pax = RM150 1,550 1 Indicator is a measurable entity related to a specific information need such as the status of a factor, change in a threat, or progress toward an objective. E.g. number of trees planted, water quality index, number of encroachment reported, etc.

3 Total 5. Disclosure of Conflict of Interest. Potential conflict of interest must be disclosed. Each disclosure will be reviewed individually before decision is made. Please disclose: i. Whether or not you / your company is currently providing any services to any project(s) within WWF- Malaysia. No Yes, please state project name and duration: ii. iii. Whether or not you are currently attached with the government No Yes, please state name of department/institution: Whether or not you are related to a staff / board member of WWF-Malaysia No Yes, please state name(s) and relationship: iv. Whether or not you are an ex-employee of WWF-Malaysia No Yes, please state employment period: 6. I am interested to apply for the Youth Action Grant (YAG) by myharapan. This additional funding will be used to. Applicant s age: Amount of grant requested (budget breakdown for this additional funding should also be listed in section (5.)): (Note that myharapan has its own selection process and may require additional information and effort from the applicant.)

4 REPORT TEMPLATE COVER PAGE [TYPE OF REPORT 2 ] [NAME OF PROJECT] [Reporting Period] [Project Period] [Project picture] [Report prepared by] [Date of report] 2 Type of report: Quarterly Report, Mid-term Repor, End-of-Project Report

5 TABLE OF CONTENT 1. INTRODUCTION Describe background of this project and elaborate its objectives. 2. ACHIEVEMENTS & IMPLEMENTATION OF WORK PLAN Elaborate achievements of the project during its reporting period, effective implementation of work plan, whether the team is able to implement work plan according to schedule, provide justification on work plan implementation. 3. CHALLENGES & STRENGTH Discuss the challenges and strength of this project that enabled or hindered performance. 4. LESSONS LEARN Describe key lessons that you have learned and believe are important to share with others. 5. NEXT STEP & FEEDBACK FROM WWF-MALAYSIA PROGRAMME PARTNER Describe what the next step of the project is after the funding period. WWF-Malaysia Project team to provide feedback on this project, to elaborate how this project has contributed to their project objective(s). 6. APPENDIX o APPENDIX 1: Summary of budget and expenditure o APPENDIX 2 (optional): Photos of major activities o APPENDIX 3 (optional): Training module, programme