APPLICATION FORM FOR ASSISTANCE FROM THE AFRICAN WORLD HERITAGE FUND This template is the riginal assistance request frm which when sent shuld cver all the questins asked. It can be adjusted t accmmdate aspects nt cvered r the length and detail f yur request. It shuld be filled in, in English r French and sent with supprting dcuments and a cncept prpsal as per the frmat prvided in sectin C t: - The African Wrld Heritage Fund 1258 Lever Rad Headway Hill Midrand, 1685 Suth Africa. Tel: +27 [0] 11 256 3551 E-mail: inf@awhf.net Clsing Date: 31 st August 2015 Please nte that the results will be annunced in July 2016
This applicatin frm is in three parts: In sectin A: In sectin B: In sectin C: In sectin D: Details f yur rganisatin. (This dcument assumes the applicant rganisatin is t be the beneficiary r will functin as an accunting and reprting agency if the beneficiary f the fund has limited capacity t perfrm such) A descriptin f the funding need and amunts requested A prject Plan frmat t be fllwed Guidelines and a Checklist f required dcuments. SECTION A: GENERAL INFORMATION A.1 State Party: A.2 Name and psitin f persn making the request: A.3 Name f institutin applying fr assistance: A.4 Cmplete address (pstal, physical, fax, telephne and email address): A.5 Name and psitin f an alternate cntact persn: A.6 Head f the requesting institutin: A.7. A.8. A.9. Type f rganisatin applying (e.g. Ministry, Parastatal, Nn-prfit Organisatin, Cmmunity Based Organisatin, Nn- gvernmental Organisatin, etc): When was yur rganisatin established? Registratin number: (please attach prf where applicable) A.10. Yur rganisatin s bank details: Accunt Name: Accunt Type: Accunt number: Bank: Swift Cde: A.11. Describe the main purpses and activities f yur rganisatin (5 lines):
SECTION B: NATURE OF ASSISTANCE B.1 (Tick preference r give a summarised descriptin if nt cvered belw) Preparatry Assistance Cnservatin management initiatives f listed sites Other B.2 Prject Title: B.3 Categry f Site (tick belw preference) Culture Nature Mixed B.4. The prject is: - lcal - natinal - sub-reginal invlving a few States Parties frm a regin - reginal invlving mst States Parties frm a regin - internatinal invlving States Parties frm different regins If the prject is natinal, sub-reginal, reginal r internatinal, please indicate the cuntries/prperties which will participate/benefit frm the prject: B.6 Indicate if this prject will als benefit ther natinal and Wrld Heritage prperties, and if s, which nes and hw?
B.7 Hw will the prject benefit Wrld Heritage site cmmunity neighburs B.7 Prject Lcatin: What is the name and area where the prject will be managed and/r implemented (tick and give prperty name in the space prvided): a) Wrld heritage prperty, b) sites n the tentative list, c) designated natinal sites d) thers specify: _ Name f the prperty B.8. Justificatin fr the prject a) Explain why this prject is critical B.9 Timeframe fr the implementatin f the prject (indicate whether estimated r fixed) Dates: Duratin: B.10 What is the verall budget fr the Prject and hw much is being requested frm AWHF? (indicate in US Dllars) Overall Requested frm AWHF SECTION C: PROJECT PLANNING
C.1 Cntext: Give a brief summary f the cntext within which the prject is prpsed C2. Give a descriptin f the prject prpsed? C3 C4 C5 C6 C7 C8 C9 Wh are the main stakehlders f the prject and its beneficiaries? What is the verall gal f this prject (als describe the means f verificatin fr assessment f the stated gal)? What are the Prject bjectives/purpses (als describe the means f verificatin fr assessing the stated purpse)? What are the majr utputs (results r utcmes), (als describe the means f verificatin fr assessing the stated utputs)? What will the majr activities per utputs be? What will be the financial, human and equipment inputs be? What elements will be build in t sustain the prject and its utputs? C.10 Example f a wrk plan Activity ne ;.. Activities Timeframe Respnsible agent/s Activity tw : C.11 Wh will evaluate and reprt t the African Wrld Heritage Fund within three mnths befre the prject is cmplete and three mnths after the prject is cmpleted) _ C.12 State the prfiles f trainers/participants, if the prject fresees the participatin f such peple.
C.13 BUDGET BREAKDOWN a) Prvide, in the fllwing table (in United States dllars), a detailed breakdwn f csts f the individual elements f the prject including, if pssible, unit csts and shw hw these will be shared between the different funding surces. Nte: It is imprtant t als indicate what yur rganisatin and /r yur cuntry will be cntributing t the prject. Yu may wish t extend the table as necessary. Budget line 1 Items Detailed USD State Party Funds USD Amunt requested frm the AWHF USD Other surces USD Ttal USD Budget line 2 Budget line 3 Budget line 4
C.15 DECLARATION I cnfirm, n behalf f (name f rganisatin respnsible fr the verall crdinatin and implementattin f the prject ) that I am authrised t sign this declaratin, and that t the best f my knwledge all answers t the questins n this frm are accurate and I agree that prbity inspectin may be cnducted in respect f ur rganisatin. If this applicatin is successful, this rganisatin will use the grant nly fr the purpses specified in this applicatin, and will cmply with all the terms and cnditins attached t the grant. I accept that false infrmatin prvided by urselves t the AWHF wuld nullify this applicatin and that any funds received by us n the basis f such false infrmatin wuld have t be refunded. Name: Psitin held in rganisatin: Date: Signature:.. C.16 SIGNATURE ON BEHALF OF STATE PARTY Full name: Title Date : : C.11. ANNEXURES (number f annexes attached t the request)
SECTION D: GUIDELINES AND CHECKLIST D1. Funding areas The Beneficiaries f the fund are African state parties that have ratified the 1972 Wrld Heritage Cnventin. Prjects that are eligible fr funding are thse with intentin t carry ut wrk within the tw brad categries; The Identificatin and preparatin f African sites fr inclusin n Natinal Tentative Lists and nminatin fr inscriptin n the Wrld Heritage List The cnservatin and management f sites already inscribed n the Wrld Heritage List The further training f heritage experts, cmmunity custdians f sites and site managers D2. Filling in the frms Prvide accurate infrmatin Cmplete all relevant sectins Ensure that all the required supprting dcuments are included in yur applicatin D.3 Belw is a checklist f the cre funding areas and cmpulsry dcuments t be attached per funding request type CORE FUNDING REQUEST AREAS Preparatry assistance (natinal and Wrld Heritage Site Inscriptin) Cnservatin management initiatives f listed sites Draft reprt f site ptential fr listing Letter frm relevant heritage authrity supprting such listing Prject implementatin plan Include surces and amunts f supprtive funds (if any) Indicatin f hw cmmunities will be invlved in the prject Outline f previus cnservatin management initiative Prject implementatin Plan Letter frm the Head f the site apprving the initiative Include surces & amunts f supprtive funds (if any) Indicatin f hw cmmunities will be invlved in the drafting f the plans
The Capacity Building and Technical supprt prjects can either be part within a request fr preparatry assistance r a part within the cre funding area f cnservatin management initiatives f listed sites. CAPACITY BUILDING AND TECHNICAL SUPPORT PROJECTS Further Training f heritage experts and site managers Awareness & Educatin prgrammes fr cmmunity site custdians CV s f prpsed training service prviders/r prf f training institutins experience Include surces & amunts f supprtive funds (if any) CV s f experts and site managers Prf f curse registratin and /r letter f acceptance Detail f planned training Include surces & amunts f supprtive funds (if any) AWHF des nt prvide funding t individuals. When training funding has been apprved it is managed by the training institutin f chice r nminating heritage site which can submit expenditure and prgress reprts t AWHF. In additin t the applicatin frm and supprting dcuments, The African Wrld Heritage Fund may require further infrmatin frm yu. Yu will be cntacted if and when such infrmatin is required Yur applicatin must reach AWHF by the clsing date and an acknwledgement f receipt letter will be sent t yu. If it was received after the clsing date yu will be ntified. Nte that n applicatins r attached dcuments will be returned t yu. A letter f the utcme f yur applicatin will be sent yu nce recmmendatins have been made. If yur applicatin is successful, yu will be asked t cmplete a funding cntract and return it t the African Wrld Heritage Fund.
Key dates: 31 st August 2015 Clsing date fr applicatins 15 th July 2016 Ntificatin t all applicants Criteria fr Funding Awards A. Funding Categries There will be tw funding categries; The Small Assistance Grants and the Standard Assistance Grant. The Small Assistance Grant is a prpsal requesting funding frm $10 000 and belw. This funding request shall be recmmended by the Directr f the African Wrld Heritage Fund t the Chairpersn f the AWHF fr apprval. The Standard Assistance Grant is a prpsal requesting funds frm $10 000 and abve, which shall be subjected t a review by the AWHF Bard. B. Guidelines fr funding awards fr the Small Assistance Grant The Directr f the AWHF will put tgether a team f heritage experts in the area that the prpsal seeks supprt nt less than three and nt exceeding five peple. Prpsals shall be circulated electrnically. On the basis f the key funding Criteria utlined in Sectin D, experts will indicate whether the stipulated criteria has been met and where there are shrtcmings make recmmendatins. Based n the expert reviews the AWHF Directr will make recmmendatins fr funding supprt t the Chairpersn f AWHF. C. Guidelines fr funding awards fr the Standard Assistance Grant AWHF will seek advice frm heritage experts n the technicality and practicability f the prpsed prject. These reviews will be submitted t the AWHF Bard fr final decisin. The criteria utlined in Sectin D will be fllwed. D. Key Funding Criteria Prpsals will be funded n the basis f: Hw clsely they match the Funds gal The prject design and implementatin The use f innvative appraches Clearly articulated, realistic and measurable utcmes Meaningful rles f and clse cllabratin between state parties Meaningful rles f and clse cllabratin between agency submitting prpsal and cmmunity If there shuld be stakehlders invlved evidence f endrsement f prject by stakehlders Where technical supprt is being sught, r the prject is being submitted n behalf f a cmmunity r site the lead rganizatin s cmpetencies, practical experience, human resurces t implement the prject within the prpsed timeline and manage grant funds as well as develp prject reprts The capacity t leverage funding frm ther surces will be an added advantage