recabaso round 2 application form

Regional AIDS Training NetworkP.O Box 16035-00100, Nairobi, Kenya

Tel: +254-20-2635929, 2635938, Mobile: +254 73499975, 724255849Email: [email protected], Website: www.ratn.org

Appendix to the Expression of Interest

APPLICATION FORM

A.1 Applicant identification

INFORMATION REQUIREDCONTACT DETAILS Address:

Telephone:Fax:E-mail:Website:

REGISTRATION DETAILS

Date of registration:Country of registration:Registration number:

A.2 Contact person

INFORMATION REQUIREDTITLE Mr/Ms/Dr/other NAME Surname:

First name: DESIGNATIONCONTACT DETAILS

Email:Tel:

B. Applicant Profile

What is the mission statement of the applicant organisation?

of 6



B1. Type of your organisation (please tick/shade) appropriately:

(a) Community-based organisations (CBO) working on HIV and AIDS

(b) National Network of AIDS Service Organisations

(c) National Civil Society Organisation working on HIV and AIDS

(d) Other Specify

B2. Please list any organisations /bodies that your organisation is a member of or is affiliated to;

B3. Provide the following details on size of your organisation in terms of number of permanent staff and budget in the last three (3) years

Year No. of full time staff Annual Budget (US$)201220112010

B4. Please provide an overview of the project (s) or programmes your organisation has implemented in the past three years:

Name of project Keys Project Outcome(s)

Year(s) of implementation

Donor(s)

1.2.3.

C. Applicant’s Information for RBM intervention

C1. Describe how your organisation applies or understands Results Based Management principles?

of 6



C3. Please answer the following question by ticking the appropriate box

i. Question Advanced Beginning Not Started

Don’t know

ii. To what extent is your organisation using results information to manage and adjust on-going operations, strategic plans, policies and resources

iii. To what extent is there tangible support from management for building and supporting results-based management?

iv. To what extent is RBM-based training available to managers and staff throughout the organisation?

v. To what extent do the appraisal systems in your organisation relate individual accomplishments to outcomes?

vi. To what extent do your organisation’s values and ethics reflect an outcome focus?

vii. To what extent is risk management systematically practiced in your organisation and linked to outcomes

viii. To what extent does your business plan/strategic plan specify organisation-wide performance expectations that are clear, concrete and time-bound?

ix. To what extent are outcome measurements linked to financial measures

x. To what extent is evaluation integrated into the management of programs and policies

xi. To what extent are results data used for internal managing?

of 6



C4 Overall, how would you rate your organisation in terms of practice of Results Based Management?

1. Advanced 2. Not started

3. Beginning 4. Do not know/ Not sure

C5. Briefly describe why your organisation is applying for capacity building for Results Based Management (RBM) (If space is not enough use separate page but maximum one (1) page)

C6. Does your organisation have the following documents? Please tick as appropriate Type of Document Yes No Not

Applicable1. Constitution for the Organisation2. Registration certificate3. Audited Accounts for last Financial Year4. Annual Report for last Financial Year5. Organisational chart6. Current Strategic Plan 7. Annual work-plan8. Monitoring and Evaluation Plan/Framework9. Organisational Capacity Statement/Profile

C7. If yes to C6 (6) above, is the current Strategic Plan fully funded? (tick one)

Yes fully funded Yes Partially funded Not funded

………………………………………END…………………………………………

of 6



ANNEX 2 to the Call for Expression of Interest

RECABASO/11/12RECABASO: Eligibility Criteria

IMPORTANT: RECABASO Team reserves its right to verify the accuracy of the information provided by the Applicant by means of due diligence, if required.

ELIGIBILITY CRITERIA System of appraisal (for RECABASO use only)

Yes / No

1.1 The Applicant is an AIDS service organisation

1.2 The Applicant is based in the Eastern and Southern African region

1.5 The Applicant has declared interest in RBM capacity building

1.6 The Expression of Interest is prepared in accordance with Annex 1 to the Call for Expression of Interest. All necessary supporting documents are provided.

1.7 The Expression of Interest and the relevant appendices/annexes are duly signed.

1.9 The Expression of Interest is submitted both by registered mail and e-mail.

1.10 The Expression of Interest is submitted within the Deadline.

of 6



ANNEX 3 to the Call for Expression of Interest

RECABASO/11/2012RECABASO: Award Criteria

No. AWARD CRITERIA Evaluation (weighting)

For RECABASO use only

1.1 Eligibility criteria met as per Annex 1 30

1.2 The applicant’s organisational governance structure 20

1.5 Applicant’s demonstrated need and interest in Results Based Management

20

1.6 Applicant’s potential to demonstrate results 10

1.7 Assessment of relevant supportive document 20

Total 100

of 6

recabaso round 2 application form

Documents

applicant organisation

resultsbased management

management rbm

results information

management of programs

risk management

management principles

registration number