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Please attach separate sheets if additional space is required when completing questions.

Please attach the following documents to this application:

• A detailed project proposal with a clear and detailed budget breakdown for a one-year period.
• A clear indication on what the funding required from the Capricorn Foundation will be used for.
• An indication of which portion of the budget already receive other donor support.
  (Please specify the donors)
• The organisation’s constitution.
• The latest annual report.
• The latest financial statements
• Certificate of registration as a welfare organisation, if applicable.

SECTION A: INFORMATION ABOUT THE APPLICANT ORGANISATION

Contact Person

Organisation Banking Details

Status of Organisation

Define the current or projected number of staff members required for this project

SECTION B: INFORMATION ON SPECIFIC PROJECT FOR WHICH FUNDS ARE REQUESTED

In line with our investment areas and the Sustainable Development Goals (SDG’s), with a focus on, No Poverty; Good Health; Gender Equality and; Climate Action, select the field(s) which your project targets (Tick)

Budget

A detailed budget should be submitted. The budget should clearly outline the amount requested from the Capricorn Foundation, own funds and funding from other sources. Breakdown of budgets should link to activities/goods under workplan.

Project Work Plan

A detailed work plan should be submitted. Where possible, the following should be included:

• Activities to be covered during the duration of the project with the Capricorn Foundation
• Costing for activities/programmes
• Responsible person
• Period/quarter in which activities/programme will be covered

SECTION C: DOCUMENT UPLOAD SECTION