application for ngo partnership
TRANSCRIPT
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ORANGANISATION (NGO) PARTNERS APPLICATION FORM
(Section-1)
1. Name of the Project: _______________________________________________________________
(If you are applying for funding support based on the discussions, we have had over telephone, then Incorporate the name of the
project for which you need fund support. If you have not discussed with us, But still would like to apply and empanel your NGO with
us so that you will get funding opportunities in Future, then leave the name of the project blank).
2. Reference Number: _______________________________________ (as per Grant Assistances Application)
3. Name of Organisation: __________________________________________________________________
4. Postal Address: ________________________________________________________________________
_____________________________________________________________________________________________
Panchayat/Village/ Taluk __________________________________City District__________________________
State ____________________________________________ Pin Code:____________________________
Year of establishment: ___________________
Registration No ___________________ Registration Date: ________________
Geographical Area of Operation/Activities: __________(Name of City/Village District etc)_____________
5. Aims & objectives of Organisation:
Vision & Mission:____________________________________________________________________
____________________________________________________________________________________
6. List of NGOs Executive Body / Office Bearers / Governing Body / Board of Directors / Trustees
(Indicate EB, OB or BOD as the case may be)
Name of Person Profession /Occupation
Designation in the Organisation:
Since (Month/Year)
7. List of activities and source of its funding
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8. Present Institutional Capacity:
Paid Volunteer
(i) No. of Technical Staff __________ ___ ______
(ii) No. of Professional Staff __________ ___ ______
(iii) No. of Total Staff __________ ___ ______
(iv) No. of Management/Support Staff __________ ___ ______
(v) Any other (specify) ____________________ _____________
9. Achievements made by the NGO (please attach a detailed report of short term and long term activities of the
NGO for the last 3 years or less)
10. Present Assets of the NGO:-
1 Building Rented/Owned
2 Land
3 Movable Properties
4 Furniture
5 Equipments/Computers
(Specify kinds & quantity)
6 Vehicles (Specify type and quantity)
7 Any other (specify)
(Attach a copy of updated inventory list)
11. Name of Contact Person/Coordinator: ________________________________
Profile of the person:_______________________________________________________
_______________________________________________________________________________
Address: _________________________________________________________________
Phone/Fax No.: (______) _________________________________________________________
City Code
Email: ______________________________ Website:__________________________________
12. Income & Expenditure during last financial year:
Income Rs._________ lakhs
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Expenditure Rs. _________ lakhs
Terms & Ethics
The Philosophy of our Organisation is built upon the idea of Joyofgiving with organisation who work with their passion
toward development of society
Review/comment on Core Committee work product
Recognize the organisation member who will not attend the meetings, and you may not want to beleft out of this
process. Thus, a Core Committee has been created to perform a variety of tasks to administer this grant.
At certain points, the Core Committee will share and vet information that has been produced with the Lead
/Parent Organisation. This information may be shared with a broader group of organisation, as well.
There will be times when the Core Committee will be asked to make decisions
Committee meetings can be open to the public;
Lead/Parent Organisation can attend a Core Committee meeting whenever you wish.
One monthly Meeting will be compulsory (and twice monthly at certain phases of the project)
Create Scope of Work for Required Projects
Serve on interview panel for selection of Organisation & Programs
Review work product and deliverables of the Program
Evaluate and select preferred alternative(s)
Take the initiative and ethical responsibility to exercise good judgment and recognize when the Core Committee
should consult Lead /Parent Organisation
13. DECLARATION
We hereby confirm that
i. The information provided herein above is true and correct to the best of my/our knowledge and belief.
ii. We undertake that we shall abide by the Rules and Regulations given by Core Committee
iii. Our organization is not black-listed by Government or any other organization.
We attach the following:-
i) Self Certified copy of the Registration/Renewal Certificate.
ii) Self Certified List of present Office Bearers
iii) Curriculum Vitae of the Contact Person and the Passport size photograph.
iv) Certified copy of the audited accounts of the last 3 years.(If Any)
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Place: Signature ___________________
Date: Name _____________________
(Seal of the Organization)
ORANGANISATION (NGO) PARTNERSHIP FORM (Section-2)
Reference Number: _______________________________________ Date Inducted: ____________________
Name of Organisation: _______________________________________________________________________
Panchayat/Village/ Taluk _________________________________City District__________________________
State ____________________________________________ Pin Code: ___________________________
(Tick one of the below)
Lead Organisation ( )
Parent Organisation ( )
Chapter Follower Member ( )
I have read & understood the overview of the organisation Structure &Roles & Responsibilities of NGO Partners
(Yes/ No)
CODE OF ETHICS
When evaluating organisation/committee, please apply the following code of ethics to the various situations. This is not
meant to be a list of specific but can be applied in principles to almost any conflict or complaint.
Upon Acceptance to Joy of Giving Global Foundation, I agree to abide by the following code of ethics during the service
of my Participation in the organisation.
I will provide the Quality Services
I will be truthful with Chapter Member
I will Build Goodwill & Trust among Chapter Member
I will take responsibility to fulfill the given Task.
I will live up to the ethical standards of my Profession & given Responsibilities.
I ___________________________________Agree to the terms & Conditions as part of my member in this Chapter of
________________________ (State) and we __________________________________ have understood our Roles &
responsibilities as a dedication of my own profitability to others.
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Place: Signature ___________________
Date: Name _____________________
(Seal of the Organization)
Kindly send this form directly by Past/ Courier for Below Address:
Mr.Punith Kumar
BlueBird Welfare Organisation
#38,1st main,K.P.A Block,Chandra Layout.Vijayanagar,BANGALORE 560040
Email : [email protected] Website : www.bluebirdwelfare.org
Ph : 080-23184940 Mob : +91-9739997775
Note:
Organisation /NGO Partnership have to apply the Application for any Grant Assistances.
After Applying for any of the Grant Assistance the Reference Number will be given.
NGO Partnership Application without Reference Number will be not Consider.
Separate paper may please be added, if required, while answering/providing information against eachquestion.
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mailto:[email protected]:[email protected]