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U.S. Embassy Grant Program 2012 - Application Form

Project Title
Name of the organization (in English)
Name of the organization (in Slovak)
Address (row1)
Address (row2)
Address (row3)
Represented by - Name
Represented by - Title
Background of the representative (CV(s) of key project staff)
Background on the organization (please attach a copy of the registration papers)
Any previous U.S. Government funding:Any previous U.S. Government funding
Project dates
Amount requested (in US$)
Project summary (maximum 10 lines)
Project purpose (what goals will be achieved and how the results will be determined/measured)
Project Justification (please describe the need or problems the project will solve and the target groups)
Project Sustainability
Detailed description of project activities and project timetable
Detailed budget in US$ (including justification of major items, use extra sheets if necessary)
How will you meet the program and financial reporting requirements (e.g., who will prepare the financial report?)
Other sources of support for this project (including the applicant organization)
Other organizations you applied to with the same project and status of your application
Applied in (city/town or other location)
Date of Application
Attach your files here
All attachments together must not exceed 7 Megabytes.

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