U.S.

EMBASSY GRANTS PROGRAM

APPLICATION FORMAT
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1. GENERAL INFORMATION:
1.1. Applicant Organization (skip to 1.2. if applying for individual grant)
a. Organization name (English): Public Asociation Socio-Ecological "CIVIS"

b. Organization name (Original Legal Name): Asociaia Obteasc Socio-Ecologic "CIVIS"

c. Website: www.civis-ong.org d. Fiscal Code: 1014620007027

1.2. Applicant Information

a. Last Name: Gandrabura b. First Name: Mihail c. Title: Director

d. Street address: s.Braviceni e. City: rn. Orhei f. District:

g. Tel: 078551333 h. Mob: 078036373 i. Fax: j. E-mail: civis_ong@yahoo.com

2. BACKGROUND OF ORGANIZATION OR INDIVIDUAL

2.1. Description
Public Association Socio - Ecological "CIVIS" is a nongovernmental, independent and apolitical organization,
founded in 2005. AOS-E "CIVIS" manages programs in the educational, social, developing projects aimed at:
research and education, access to information for all applicants, trainings, publications, participatory arts, etc.
Mission. AOS-E "CIVIS" sustainable development, democratic principles and values informing and supporting
children and youth initiatives, which can be achieved by stimulating domestic intellectual climate for all
members of the community environment that is sensitive to national and international needs. Purpose Making a
change of mentality on the perception of the child and youth as a separate individual with rights, views and
personal opinions, based on foreign examples. Promoting partnership between APL triple-based NGO
BUSSINESS Polish example and putting into application in business strategy of the organization.

2.2. Past Grants (U.S. Embassy)

AOS -E " CIVIS " did not receive grants or irredeemable financing from the US Embassy both directly, as an
applicant, and indirectly in partnership or other form .

2.3. Past Grants (Other)

2014. Project Name: ESTAFETAPL-MD consolidation of democracy
Period: 15.03.2014 30.11.2014
The value of the grant: 80.015 PLN about 21.415$
Donor: Polsko-Amerykaska Fundacja Wolnoci, Fundacja Edukacja dla Demokracji
RITA: Program "Przemiany w Regionie"
2013. Project Name: "DISCOVER MOLDOVA- creating a national network of partnerships and promoting the
tourism potential of Orhei at the International Tourism Fair in Poznan "
Period: 15.02.2013 30.11.2013
The value of the Grant: 80.015 PLN about 22.350$
Donor: Fundacja Solidarnoci Midzynarodowej Poland
2012.Project Name: MOLDOVA local partnerships for regional development
Period: 01.06.2012 31.01.2013
The value of the grant: 66.640 PLN about 18.620$

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 Polish- American Freedom Foundation through RITA program ( program that supports regions in transition ) .
2011.Project Name: ORHEI multicultural development in terms of agro tourism
Period: 01.12.2010 31.05.2011
The value of the grant: 40.000 PLN about 11.200$

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 3. PROJECT DESCRIPTION:

3.1. Project information

a. Project Name: Violence Prevention Center, Civic Involvement and Professional Orientation of the Youth

b. Duration (months): 12 c. Start date (mm/dd/yyyy): 3/1/2017 d. End date (mm/dd/yyyy): 3/1/2018

3.2. Executive summary:

The children and the teenagers of nowadays increasingly distinguish through a rude and aggressive behavior
(verbal, factual) both towards people around them as well as towards the members of the family, friends,
colleagues, etc. They adopt a form of aggression either because they fallow the parental models ,or those
promoted through mass-media or, simply, because no other alternative is offered to them. We are concerned about
many material things and we don't put our accent on things related to our soul, our feelings, the fundamental
human values. That's why, the lack of feelings in the family leads later to a form of aggression. With this in mind
we have decided that the most efficient solution is the prevention of violence through the implication of the youth,
namely by the creation of a center that will consist from several profile laboratories (workshops) with double
destination: 1.Civic Involvement and 2.Proffesional Orientation. As well within this center, the young people
will benefit from the services of a psychologist, a doctor, social and legal assistance.The ideal to which we aspire
through the creation of this center is that we want to change the young people's mentality and to transform the
society's approach refering to this kind of centers and to see them as centers of resources,as a unique family, as a
civic platform for community cooperation.

3.3. Project Justification:

The causes of the problem are:

- Most of the adults, including teachers, parents are not ready to transmit information or the information is
distorted.
- Locals do not possess practical skills of application in everyday life the information they possess on funding
sources, projects, project management etc.
- Lack of teams and lack of interest of the society to be involved in promoting democratic values and principles,
project management at Community level.
The effects of the problem:
- The perception of the information by the society which diminishes and distorts the content.
- Lack of practical skills of a team and interest in the application of information society possessed allows creating
gaps in the use of all means of community development.
Solving the problem:
AOS-E "CIVIS" through this project aims to solve the following problems:
- Involving young people especially of women and local ethnic minorities in civic activities and writing projects
that will lead to promoting community regionally, nationally.
- The participants of the Social Affairs Laboratory will contribute to community development, small business etc.
- The Social Affairs Laboratory through its investment caracter projects will aim to support basic food for
kindergarten, school and socially vulnerable families.
- Improving dialogue between LPA NGOs, private sector and society leading to the development community.
Solving assembly problems described above will allow the correct information society, generating personal
interest of society in community life, creating a good dialogue and cooperation between LPA, NGOs and business
to community development.

3.4. Project Goal and Objectives

Support local youth participation especially of women, minorities that contribute to promoting the values and
principles of civil and democratic society through information, counseling, social services providing community
education.
Project objectives:
O1- Promoting the exchange of ideas, solutions, political and economic analyzes.
O2- Development activities and projects which would be self-financing.
O3- Strengthening capacities of communication between young people through acces to information
communication technologies, etc.
O4- Creating an enabling environment for knowledge, development and application of democratic leadership

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 skills, negotiation, project management, personal business community impact.
O5- Information campaign, training in order to explain the concept of the project and identify interested people to
get involved in community activities.
O6- This web site www.valeni.org in order to ensure democratic principles of good governance, transparent
decision-making and community activism.
O7- Motivating youth to participate in civic activities.
O8- Creation of Cooking Abilities Laboratory.
O9- Creation of Cultural Heritage and Vocational Skills Laboratory.
O10- Creation of Social Affairs Laboratory.
O11- Creating a strong core in order to develop community projects.
O12- Editing and publishing guides "Leadership step by step", "Project Management" and "Business
Community".

3.5. Project Activities

I. Name of the activity: Information campaign. Press Conference - Official opening.
The purpose of the information campaign is to explain the concept of the project to the community and generate
interest in civic participation of residents in this project.
Also through this information campaign will inform the society about the purpose and expected outcomes from
achieving these trainings. Respectively by carrying this information campaign will lay the foundation of a
collaborative dialogue between civil society actors, LPA. Also information compaign will be monitored through
initial surveys developed by AOS-E "CIVS" which is the situation on the awareness and accessibility to
information of the population, distribution of leaflets and promotional materials on project finance and other
relevant information, will be taken audio interviews, video, and this experience will be published at the end of the
expected guide. In the press conference official opening will be shown a video entitled: "Valeni - a successful
story". The press conference will be part of the evaluation of the information campaign and the official opening of
the carrying project in Valeni village.
II. Name of the activity: This web site www.valeni.org
Creating the web page, aims to ensure transparency of decision-making at the local level LPA, free and fast access
to information society. Creating website will also allow information transmission that distorted our whole nature,
but now will increase confidence of civil society in LPA.
One of the advantages of a web page is that the information is accessible at any time and any representative of the
community is able to access it without having to go to the mayor's office.
Besides information function the web site will promote the image and role of Valeni village ,Cahul district both
regionally, nationally and internationally which from our point of view will open up new avenues of cooperation.
On the website will be published the results of the project's activities as well as the activities of the mayor, the
council, interviews, audio / video etc, which will lead to transparency and will increase confidence and efficient
dialogue between LPA and the rest of the community .
III. Name of the activity: Creation Cooking Abilities Laboratory.
This laboratory will have double destination:
- The formation of the cooking skills through youth, especially for those that come from numerous families, who
sometimes have to take care about their younger sisters and brothers whose parents are at work or they are gone
abroad, but as well for young girls who ,in the future, will found their own families and they will need to have this
cooking abilities.
- The second destination of the laboratory and the most important one is that the young people will cook and as
well they will serve the food, especially for those who come from socio-vulnerable families, because there were
discovered cases when these people don't have anything to eat or they did't eat several days, this way the center
will be the only opportunity for them to have a hot meal.
- Another destination of the laboratory is that it will serve as a source for proffessional orientaion.
IV. Name of the activity: Creation of Cultural Heritage and Vocational Skills Laboratory.
-This laboratory aims to harness the cultural heritage and the local cultural potential, as well as the development
of the vocational abilities such as : crafts, traditions which over time are lost.
- But as well within this laboratory we want to promote a healthy way of life, with the purpose of bad social
habits prevention, such as: acohol, smoking, drugs and street children phenomenon.
- Another destination of this laboratory is that we want to organize a social theatre in open air.
V. Name of the activity: Creation of Social Affairs Laboratory.
Preparing and conducting of the Social Affairs Laboratory. Participants, will be instructed how to write projects
and how to obtain European funding. As well they will be instructed how to open their own small business. This
is a good opportunity to open new jobs.

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 VI. Description of the activity: Editing and publishing guides (books of reference) "Leaders of Democracy",
"Project Management".
Editing and publishing the guides "Leaders of Democracy" and "Project Management" will primarily have an
informative role in the initiation and training of leaders and writing projects. These guides are intended not only
for
those members who participated in trainings but also for those participants who did not participate. They will
serve as a key for information transferability.
These books of reference will be as a support for course participants at the training seminar on providing
information services, training, etc., to other communities, organizations interested in writing projects etc., but as
well as professional training because there is lack of such specialists.
The content of those guides and some of the materials will be developed together with the participants so we will
ensure the availability of the is accesible for anyone.

3.6. Monitoring and evaluation

Monitoring, Evaluation, Reporting and evaluation data will be collected 4 times (initial, intermediate (2 times)
and final project).
To make an effective monitoring and evaluation of our project, we considered that we have to take into account
the following indicators:
- Amount, Financial, Quality, The process, The impact. Indicators mentioned above will have double effect as it
will serve for monitoring and internal evaluation of AOS-E "CIVIS" and for the preparation of reports to donors.
The methodology
Data will be collected for analysis by the method PAPI (Paper aided personal interview) face to face interviews
with a sample of 600 adults aged 18+.
Sampling: probabilistic by step.
In the election of the respondent will be included following steps:
Step achievement interviews will be over two or three households. On every street will be conducted at least 10
interviews. Households will be selected on the same principle over two, three.
Also in the monitoring and evaluation (initial, intermediary and final) expected performance of 94 semi-structured
in-depth interviews. The necessary data will be collected evaluation process 4 times (initial, intermediate (2 times)
and final project). Interviews will be conducted face to face by the team (volunteers AOS-E "CIVIS") of
interviewers. Structure of the questionnaire
The questions included in the questionnaire will be opened and closed. They will then be quantified and
interpreted statistically. Data interpretation will be made by a committee of project monitoring and evaluation
(LPA representatives, AOS-E "CIVIS" community leaders) that will provide an interpretation of descriptive
statistics and multi-criteria. This will also realize the interdependence of opinions target - groups analyzed and
their impact on the local situation.

3.7. Key Personnel

Gandrabura Michael - President AOS-E "CIVIS" Trainer
Project Coordinator (100%)
Negru-Stoica Eugenia, Trainer
Project Assistant (100%)
Eni Silvia - chief-accountant
Project Accountant (100%)
Stirbet Silvia - mayor of Valeni village, Cahul District, Speaker
Wiesawa Kowalska - NGO president TK "Echo Pyzdr", Poland. Trainer
Przemyslaw Kowalski - NGO president LOT - Polish Trainer
Sawomir Musio Wjt Gminy. mgr in. (mayor of the village) Poland. Trainer
Krzysztof Nosal - Kaliski Starosta (President district) Poland. Trainer
Janusz Kujawski - Specialist Powiat Kalisz attracting investments. Poland. Trainer
Melnicenco Catherine - Project Manager UNDP Moldova. Trainer (60%)
Oleg Rotari - Youth Cultural Association ORMAX - president. Drochia. Trainer
Editor Guide "Project Management", trainer. (40%)
Galina Maslinkova - Public Association "ECHO XXI" s.Tvardita Taraclia. Trainer
Editor Guide "Leaders democracy," trainer. (40%)
Manager Cooking Laboratory
Teletin Elena - Trainer (100%)

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 Manager Cultural Heritage and Vocational Abilities Laboratory.
Burca Mariana - Trainer (100%)
Manager Social Affairs Laboratory
Stirbet Ilie - Trainer (100%)

3.8. Project Partners

The regional role of LPA, the mayoralty of Valeni consists in providing its own contribution to the project, support
in the organization and making trainings and other activities during the project.
The partners from the EU were identified and consist in consulting, monitoring, assessment and informational
support during the trainings.

3.9. Strengths and Innovation

The AOS-E "CIVIS" possesses extensive experience of implementing the 2009 European projects in partnership
with Towarzystwo Kulturalne "Echo Pyzdr", Poland, the only organization in this area of the country, we believe
that the implementation of this pilot project, the activities carried out will, in an organized and professional
training, increase the quality of future leaders, senior managers, knowledge diversification, improving expertise,
promoting exchanges experience and best-practice pickup, increasing the number of projects financed from EU
funds, a degree of coordination and implementation of national and European policy and gain greater number of
specialists in specific issues of local and central government.
Also consider that the elements of the project innovators following:
- Beneficiaries will have professional trainers specialists, expert UNDP Moldova, five experts from Poland that
besides the exchange of experience will come with concrete proposals (Valleni Town hall will identify a Town hall
from Romania with which they will have experience exchange) as result of carrying out this project;
- Create a professional nucleus in writing their designs and stimulating the creation of an NGO community
(something new to the community, and have no idea what an NGO is and how it works);

3.10. Sustainability
The sustainability of this project is to distinguish between the following:
The financial aspect: After the termination of financing, project financing will come from its own funds, the main
sources: local budget participation fees for approved training programs, sponsorships, identification of new
funding.
Institutional aspects: The applicant and partners will continue their current activities after project completion with
improved performance as a result of experience gained and results developed during the project implementation.
Material resources acquired through project awareness campaign strategy, developed guides will be used to
conduct other training programs in neighboring towns and other regions of the country.
The results and experience gained in the project will be integrated into local development strategy. Transferability
to other people looking for a job who want to move from the status of inactive / unemployed people occupied
status in a society restraint will be achieved by the possibility of participating in a wide range of programs
authorized offering - a way concrete to increase the degree of employability in society. It is intended that after
completion of the project, but the authorization of the training and experience acquired to be transferred to
multiply the effects of the project.The participants in the laboratories which eventually will be motivated to
establish an NGO having equipped technical equipment procured under this project and ongoing support guides
that can provide both community and for the neighboring localities and other localities or regions, or other
organizations will need these services in the region.

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 4. REQUESTED BUDGET:

4.1. Budget Summary

Category Description/details Requested
Executive director $(100%) 160 x 12
Personnel Accountant $(100%) 90 x 12 $4,800.00
Project Assistant $ (100%) 150 x 12
Fringe Benefits $0.00
Travel
Equipment
Paper and supplies for binding and laminating machine (700 copies guide)
1000$
Press services 30x12=360$
Supplies $5,410.00
Office rent 200x12= 2400$
supplies for training 150x3=450$
office suplies 100x12=1200$
Trainer (3) for the three training 40x36=1440$
Food for participants (first training) 25x2x6-=1500$
Contractual Food for participants (second training) 25x2x6-=1500$ $6,390.00
Food for participants (third training) 25x2x6-=1500$
Fuel 150x3=450$
Creating Web Pages 350$
Other Direct Maintenance web page 80x12=960$
$2,260.00
Costs Domain and Hosting 50$
Writing guide 300x3=900$
Indirect Costs $0.00
Total
Requested:
$23,833.88

4.2 Budget narrative

The narrative budget of the project is attached in excel format, because of limited space, the narrative budget
wasn't attached. Please, don't take this into consideration like a deviation from the instructions.
In developing this budget we try to keep in mind the minimilizing of wages, services and equipment costs.
Towards the price of equipment and services we would like to mention that, because of depreciation of the
national currency against the dollar, necessary equipment have an increased price compared to pre-depreciation of
the national currency.

4.3 Miscellaneous
This is a pilot project for the Republic of Moldova. Acquisition of the equipment specified in the project would
allow optimization of some expenses like: photo, video and polygraphic services, which would allow

5. Certification:

I certify that the statements contained in this form are true, complete and accurate to the best of
my knowledge.

I am aware that any false statements or claims may disqualify my organization from receiving this
and any future awards.

I agree

By marking the checkbox below I certify that I have read and understood the instructions provided
with this form before filling out this document

I read and followed the instructions provided with this form

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 PLEASE SUBMIT THIS DOCUMENT ELECTRONICALLY IN ORIGINAL .DOC FORMAT.

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