Application Format for the

US Ambassadors Fund
Small Grants and Ambassadors Fund Program

Small Grants and Ambassadors Fund Program

G.P.O. POB 2077, Islamabad, Pakistan
T: +92 51 2828421-23; Fax. No. +92 51 2828424
Email: info@sgafp.org.pk
Website: www.sgafp.org.pk

USAID Disclaimer: This application guideline and form for the Ambassadors Fund Program is made possible with support from the
American people delivered through the United States Agency for International Development (USAID). The contents are the sole
responsibility of National Rural Support Programme (NRSP) and do not necessarily reflect the views of USAID or the United States
Government.
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Table of Contents
Application for Grant Funding under the Ambassadors Fund Program.........................3
Section A: The Organization.......................................................................................... 3
Section B: The Proposed Project.................................................................................... 5
Section C: Declaration from the Applicant....................................................................9
Section D: Application Checklist.................................................................................... 9
Annex-1: Environmental Documentation Form...........................................................10
Annex-2: Media and Communications Plan.................................................................12

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 U.S. Ambassadors Fund

Application for Grant Funding under the Ambassadors Fund

Program

Please submit all applications via email (MS Word or PDF documents) at
applications@sgafp.org.pk or by post to:

Deputy Chief of Party

Small Grants and Ambassadors Fund Program
G.P.O. POB 2077, Islamabad, Pakistan
T: 051-2828421-23

Note:
a) Before filling this application form, please ensure that your organization is
eligible for accessing funds under the Ambassadors Fund Program and the
activities/project you are proposing is in line with USAIDs thematic
areas/sectoral priorities;
b) Provide complete information including supporting documents like cost
estimates (where applicable), NOCs & Letter of Commitments (if required) from
concerned line departments and other stakeholders. Incomplete
applications will not be processed further;
c) The space given under each category of the application is indicative.
Applicants are encouraged to use as much space as needed.

1. Date of Application: ____________________________________________

Section A: The Organization

2. Contact information

a. Name of organization:
b. Type of the organization (CBO/NGO/
Private sector/Others specify)
c. Name of the head of organization
d. Postal Address:
e. Office phone number:
f. Cell Number (organization head):
g. Fax:
h. Email:
i. Website:
j. Key Contact person Name &
Designation:
k. Contact number of Key Contact Person:

3. Registration Details of the Applicant Organization: Please attach copy of

valid registration certificate

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Registration Date: Validity of Registration (date):

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4. Legal Status: (If applicable, tick the relevant section)

Registered under Societies Registration Act 1860

The Voluntary Registered under Social Welfare Agencies (Registration and
Control) Ordinance 1961
The Voluntary Social Welfare Agencies (Registration and Control) Rules,
1962)
Registered under Cooperative Societies Act 1925
Registered under Section 42 of Companies Ordinance 1984
Social Welfare Agencies (Registration & Regulation) Act 1996
Registered under Trust Act 1882
Charitable Endowment Act 1890
Others, Please specify:______________________________________________

5. Organizational Funding Source

What are the major funding sources of your organization? Please Tick the relevant
categories:
Donor organizations national and
international
Endowment
Government federal and/or provincial
Philanthropists/individual donations
Private (corporate) sector
Members fee and contributions
Others specify:

6. Details of Ongoing & Completed (donor funded) Projects

Enlist ongoing and completed projects (during last three years), placing the latest
project on the top
Project Donor/Fundi Project Major Project Total
ng Source Location Outputs Duration Budg
(District/Teh (From et
sil) To) (Rs.)

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Section B: The Proposed Project

Project Title:

Sectors: Please tick () the relevant box

Vulnerabl
Culture Disaster
Social Small-Scale
e Preparedness
Entrepreneurs Energy and the
Populatio
hip Solutions Arts
ns
Project Location:
Province(s) District(s) Tehsil(s) Union Council(s)

1. Project Rationale/Need Justification:

Describe in detail the situation/circumstances which have led to the need to develop
the proposed project. Support your arguments with primary and/or secondary
research data and statistics. Please give complete and appropriate references where
required. The projects need to be demand oriented that meet the actual needs of the
community.

2. How is proposed project realigned with organizations vision/mission and

previous work experience?

3. Project Objectives and Key Outputs/Activities

Please narrate the project objective(s) and details of key outputs/activities. The
objectives must be Specific, Measurable, Achievable, Realistic & Time-bound.
Project Objective(s):

Key Outputs/Activities (please add more rows if required. The activities

should be in line with desired objectives)
1.
2.

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3.
4.
5.

4. Implementation Methodology
Please give a detailed implementation methodology with a systematic flow of
activities while focusing on the following:
How will your organization implement the project (this should cover details like
who, what, why, when, how and where); and
In case the project involves partnerships with other stakeholders, explain in
detail the distribution of roles & responsibilities.

Note:
a) Please provide copies of NOCs/permission letters/other relevant documents if
required from the concerned authorities to carry out the proposed activity

5. Proposed Project Beneficiaries

1. Provide gender disaggregated details & numbers of the proposed beneficiaries
2. Please elaborate how the proposed project beneficiaries (individuals,
households, institutions etc.) will be selected. This should also include how
project will benefit minorities, if any, physically challenged persons and youth.

6. Environmental Impacts of the Proposed Project

Please note that environmental consequences of the proposed intervention (if any)
need to be identified, mapped and addressed at the planning & design stage.
The organization is therefore required to fill an Environmental Documentation Form
(EDF), given with the application as Annex-I.
For assistance in the filling of these forms you are advised to consult the detailed
guidelines given at SGAFPs website www.sgafp.org.pk

7. Details of the Proposed Team for Project Implementation

Please provide information of the key staff proposed for the project with relevant
technical skills and responsibility given under the proposed project. Also provide their

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CVs (not more than 4 pages each) indicating background information & stating
relevant experience.

S. Name Proposed Qualificati Total Currently

No Position on Working working with
. Experience your
organization
(Y/N)

8. Monitoring Strategy
Please explain how your organization will ensure the following:
1. Monitoring project interventions for operational transparency (programmatic as
well as financial), and
2. Information management for reporting and documentation purposes

9. Media and Communications Plan

As mentioned on SGAFPs website (www.sgafp.org.pk) and explained in the
Application Guidelines, applicant organizations understanding and commitment to
comply with the Media and Communications Plan during project implementation is
mandatory for accessing SGAFP grant funds. Please send the completed Plan (given
as Annex 2) along with the application. The applications received without the
completed plan will not be entertained.

10. Cost Share

The Ambassadors Fund supports local self-help initiatives where applicant
organizations and communities are willing to provide significant local contribution in
cash, labor or material. Please provide details how your organization will arrange this
contribution and budget it accordingly. It is important to note that after the approval
of project, your organization will be required to provide documentary evidences on
the mobilization of cost share and its expenditure.

11. Itemized Budget Details of the Proposed Project (Pak. Rupees):

Itemized budget is an important component of the proposal and a critical element in
determining the eligibility of applications. Therefore carefully read below given
instructions and provide itemized budget on the given format.

Instructions for Budget Preparation:

Provide detailed breakdown of budget, do not give a lump-sum budget.

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Provide a breakdown of how the cost share will be provided (in cash, labor or
material)
Provide detailed breakdown of the project activities as mentioned in the project
proposal and provide budget for each activity separately.
The SGAFP will fund only the direct project activities cost relating to direct delivery
of goods and services to beneficiaries.
Unrelated organizational overheads, administrative/supervision costs
(like salaries of the management of applicant organization, office rent
etc.) and profit will not be funded by SGAFP.
The SGAFP assumes that grant applicants will already be in operation and have
adequate staff and most of the capacity required to accomplish the key outputs in
the proposed project.
In some cases, salaries and travel of the direct project staff, equipment and
operating expenses such as vehicle rental & fuel etc. may be permitted, where
justified, as direct project implementation costs. However salaries, benefits, and
travel and per diem rates should be consistent not only with the organizations
overall policies covering these items but also with local norms.
The budget should be in Pakistani Rupees,
Use additional sheets for detailed budget while strictly following this template.
Please provide budget narratives where required.

Activity Unit Unit No. Unit Total Funds Applica

Typ / Cost Estimat Requeste nt Cost
e Quantit ed Cost d from Share
y USAID

12. Tentative timeline of the major proposed activities

Activity Proposed start Expected completion date
date

13. Post-Project Maintenance & Sustainability

Explain how your organization plans to ensure that the project interventions and
benefits will sustain after the completion of project. Enlist concrete measures that
your organization will take in the post-project period to monitor project interventions
and provide assistance to the project beneficiaries. Also indicate recurring cost, if
any, needed to manage the post-project operations and indicate how this cost will be
managed by your organization or by communities.

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Section C: Declaration from the Applicant

S. Statements Ye No
No. s .
1. Whether organization will need necessary permissions
such as: /No Objection Certificate (NOC)/Letter of
Commitments (LoC)/Memorandum of Understanding (MOU)
from government and/or other stakeholders to implement
the project? (If Yes, please provide a list and copies with
application)
2. The organization will be able to implement the proposed
project without creating any local conflict
3. The organization will fully comply with USAIDs
branding/marking & publicity requirements as explained at
SGAFPs website
4. The organization confirms that the project location is safe
and subject to the approval of project, SGAFPs staff can
undertake monitoring visits safely.
5. The organization declares that none of its office bearers
holds any political office or is involved in political activities
and that USAIDs assistance will not be used to gain any
political mileage for the organization or any office bearer.
6. The organization confirms that the project design does not
include activity(ies) given in the List of Ineligible
Activities as explained in the Application Guidelines.

Section D: Application Checklist

S. Particulars Ye No
No. s
1. All sections of the applications have been filled as per given
directions
2. Copy of valid registration certificate is attached

3. Resumes of the proposed team members are attached

4. Necessary permissions/NOCs/LoCs/MOUs (if required) have

been obtained and attached
5. Detailed and itemized budget is attached

6. In case organization has undergone an external

organizational evaluation in the last five years, its report
has been attached with the application
7. If applicant organization has implemented a USAID funded
project, its project completion report has been attached. (In
case of an ongoing project, attach last progress report)
8. In case organization has conducted a baseline/need
assessment/rapid assessment of the proposed project area
and/or beneficiaries, its final report has been attached.
9. Organization has attached reference letters obtained from
two of its largest donors (Government, INGOs, Donor

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Organizations and Corporate entities) with whom it has

worked during the last 3 years.
To the best of my knowledge, I declare that all the above information is true and
accurate.

Sincerely,
Name: Designation:

Signatures:
Date:
(To be signed by head of organization)

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Annex-1: Environmental Documentation Form
[INSERT PROJECT NAME]

A. Applicant Information
Contractor/grantee(organization) Parent grant or project
Individual contact and title Address, phone and email(if available)

Activity (brief description) Amount

Location of activity Start and end date of activity

B. Activities, screening result, and recommended determination

TABLE 1 Screening result Recommended
Determinations
Very Low Risk

Moderate Risk

High Risk

significant adverse impact

No significant adverse impact

With specified mitigation, no

significant adverse impact
Proposed sub-activities

1.
2.
3.
4.
5.
6.
7.
8.
9.
(Continue on additional page if necessary )
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C. Summary of recommended determinations (Check all that apply)

The activity contains (equivalent regulation 216 terminology)
Very low risk sub-activities Categorical exclusion (s)
After environmental review, sub- Negative determination (s)
activities determined to have no
significant adverse impacts
After environmental review, sub- Negative determination (s) with
activities determined to have no conditions
significant adverse impacts,
given appropriate mitigation
and monitoring
After environmental review,
sub-activities determined to Positive determination (s)
have significant adverse
impacts

D. Certification:

I, the undersigned, certify that:

1. The information on this form is correct and complete

2. The following actions have been and will be taken to assure that the activity
complies with environmental requirements established under the Code of Federal
Regulations 22CFR 216
3.
These design elements and best practices will be followed in implementing
this activity, except with the approval of USAID
Any specific mitigation or monitoring measures described in the attached
information will be implemented in their entirety
Compliance with these conditions will be regularly confirmed and
documented by on-site inspections during the activity and its completion.

_____________________________________ _________________________
(Signature) (Date)

BELOW THIS LINE FOR USAID USE ONLY

Approval
USAID Project (print name) (signature)
Officer
Approved
Rejected
USAID MEO or (print name) (signature)
DMEO
Approved
Rejected
USAID comments: (if documentation is rejected, comments must be
provided to applicant)
 Annex-2: Media and Communications Plan
During the summary preparation stage, SGAFPs Grants Processing team & Media &
Communication Section work closely with the applicant organizations to develop a
multifaceted and vibrant media & communications strategy for each grantee to
highlight USAIDs assistance and enhance visibility. This strategy is divided in two
broad categories outlined below:

Community Outreach Campaign

Activities outlined below are tailored to match each project needs and objectives.
Project Opening & These ceremonies are held at the start and end of the
Closing Ceremony project. Key stake holders, local Govt. officials, community
members from schools, hospitals and beneficiaries are
invited to the event.
IEC Material All IEC material (brochures, flyers, factsheets, reports etc.)
is distributed among the communities during
ceremonies/workshops/focused groups etc.
Press Releases, Press releases are published in the widely circulated
Newspaper Articles English & local newspapers at the project start, end and
in English & Urdu upon achievement of a major milestone. Journalists site
newspapers tours are also budgeted where journalists are invited to
the project site and later on publish articles in national
newspapers such as The News, Express Tribune, and
Nation etc.

Radio/TV Campaign Depending on the nature of the proposed project and

implementation strategy, Electronic media is engaged to
run programs on Radio & TV(Local/National) to further
disseminate information to a wider audience
Documentary Depending on the nature of the project documentaries are
also budgeted in the grant

Branding & Marking

The grantee is required to propose to the Media & Communication section of SGAFP
as how they will mark the received assistance. All Branding & marking material is
marked with USAID Logo, U.S Flag & Disclaimer in English and Local language and is
approved by SGAFPs Media Section prior to display. Templates of the USAID standard
marking material i-e plaque, banner, sticker, signboard, reports etc. are provided by
the Media & Communication Section to the grantee organization once the grant
agreement is signed. Documentary evidence is provided by the grantee through
Photographs.

Permanent Plaques (Glass Displayed at a prominent location in the Grantee

or steel) Head Office & Project Office
Permanent signboards/ Installed at the project site upon completion
plaques
Banners/Standees Banners are displayed during any
meeting/workshop/ceremonies of the project
Stickers Papers stickers are used for marking of books and
other fragile material however steel stickers are
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used for small sized items such as embroidery

machines etc.
Website Acknowledgement Acknowledgment on the grantee website

Applicant Organizations vision and methodology to implement the plan

Please explain how your organization would ensure compliance with these
requirements and what would be the strategy to enhance the visibility of the project
supported by USAID. The activities proposed in the plan must also be reflected in the
itemized budget.
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