[Format 1]
Bangladesh Gender Fund, Canadian International Development Agency
(CIDA)
Preliminary Assessment Form
Organisational information:
1.
Name and address of the organisation:
2.
Contact person:
3.
Organisation’s objectives or mission (short paragraph):
4.
Does the organisation have any experience of working on the
issues addressed by the proposed project? If so please specify (short
paragraph):
5.
Status of the organisation:
NGO Bureau
registration number and date:
Date and type of
original registration (if any):
Total number of staff
of the organisation (M/F):
6.
Funding sources – do your resources come from (check all that
apply):
o
member contributions?
o
donor support? (If so, which donors)
o
consultancy income?
o
income from revolving fund?
o
other? (Please specify)
Information about the proposed project:
7.
What is the problem or issues this project addresses?
8.
What you want to achieve with the proposed project?
9.
How will this project contribute to progress toward gender
equality (to reducing inequality between women and men)?
10.
How does the project fit into your organisation’s overall
strategy?
11.
Who will you be working with? (for example project participants,
partner organisations, government services, policy bodies, etc)
12.
What are the main project components and activities, and the time
frame?
13.
What is your budget estimate (in the form below):
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Proposed programme Components
(add rows as required) |
Requested from Gender Fund |
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14.
Do you envisage any contribution in cash or kind?
(The
completed format should be no longer than 3 pages.)
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Section |
The
proposal should not be more than 6 pages (excluding annexes). |
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1.0 |
Organizational information |
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1.1 |
Experience |
What is your organization’s experience in relation to the proposed
project? |
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1.2 |
Management |
Describe how your organization is governed and managed (one
paragraph) |
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2.0 |
Project description |
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2.1 |
Project title |
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2.2 |
Rationale |
What problem or issue does this project address? Why is this
important for your organization to address this problem? (If there
is a geographical focus, why are you working in this particular
area?) |
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2.3 |
Results expected |
What change or changes do you expect to achieve by the end of this
project? (What will be different for the target group, or the
participants, or the policy environment or your organization)?
How
will you know that these changes have been achieved (how will you
measure or observe that these changes have occurred)? |
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2.4 |
Contribution to gender equality |
How
will the expected results contribute to progress toward gender
equality (to reducing the inequality between women and men)? |
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2.5 |
Relation to organization’s strategy |
How
does this project fit with your organization’s longer-term strategy?
How do you plan to use or build on the results of the project? |
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2.6 |
Major activities |
What are the main components and practical activities planned? How
do these components/activities lead to the results expected?
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2.7 |
Target group |
Who
will you be working with? |
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2.8 |
Project location |
Where will the project be implemented? (State district and upazilla,
if relevant) |
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2.9 |
Project duration |
How
much time (months/years) will it take to implement the project?
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2.10 |
Project management |
Briefly describe the organizational arrangements for implementation
– who is responsible for what, who will supervise, who will monitor
and report (progress and finance)? |
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2.11 |
Risks |
Are
there any factors that could hamper your ability to achieve the
results planned? Are these within your control (internal risk) or
outside your control (external risk)? Have you identified strategies
to avoid or reduce these problems? |
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3.0 |
Implementation plan |
List components and activities for each, with time frame |
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4.0 |
Budget |
Components/ activities |
Total cost |
Amount requested from Gender Fund |
Amount in cash or kind from proposing organisation (if relevant) |
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5 |
Environmental impact (if any) |
Are
there any potential positive or negative impacts of the project on
the environment? |
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6 |
Date submitted, by whom |
Date submitted and by whom (name, position in the organisation).
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7 |
Annexes |
1.
List of donor-supported projects, ongoing and completed in
the last five years (project name, donor, budget).
2.
List of current executive committee members
3.
Last annual report
4.
Last audit report
5.
List of organisational policies |
