ࡱ> Ybjbj4\\ 00000DDDDtD}NTTTTT///MMMMMMM$aPSX"N0/////"N00TT7NM M M /.0T0TMM /MM M GDdKT_` ]R I&MMN0}NFIoSoSLdKdK4oS0LP//M /////"N"N///}N////oS///////// h : BULGARIAN DEVELOPMENT COOPERATION APPLICATION FORM Name of the Development Project:Country Recipient: Region/province: Location: Duration: Planned Start of Implementation of the Development Project:(day/month/year)Planned End Date of Implementation of the Development Project: (day/month/year)Project Goals:Overall objective (s): Specific objectives: Description of the Target GroupTotal Value of the Development Project:BGNFunding requested by the Development Aid of Bulgaria% I. DESCRIPTION OF THE APPLICANT - THE BENEFICIARY Full Name of the Applicant:Applicants Country of Origin:Date the Applicants organisation was established:Scope of Activity of the Applicant:Correspondence Address:Contact Person:Phone Number:E-mail Address:Name and Position of the Person authorized to sign the Grant Agreement: II. DETAILED DESCRIPTION OF THE DEVELOPMENT PROJECT PROPOSAL Name:  Territorial Scope: State (s)Region (s)LocationAddress of the Building / Premises, where activities will be carried out Amount of Project Funding: Total Value of the ProjectAmount of Requested FundingPercentage (%) of the Requested Funding from the Total Cost of the Project   3.1. Estimates the Activity Costs: Type of Activity:Price per eachTotal BGNTotal EURPlease, add a separate row for each one of the activities. *In case total amount is in different currency than BGN, please fill in the amount in the relevant currency.* Please, fill in the amount from the third column in the equivalent amount in Euros here.TOTAL: Communication Plan (5% from the total value of the project) Expenditure for the preparation of an Independent Financial Audit of the completed project   4. Conformity: 4.1. Objectives of the Project Proposal 4.1.1. Overall Goal4.1.2. Specific Objectives 4.2. Conformity of the Project Proposal with the stated in the CALL FOR PROPOSALS priorities and areas of cooperation for development. Contribution for the realization of the Agenda 2030 for the sustainable development and of the priority goals of the respective recipient state national strategy/ development program.  4.3. Description of the Target Group  5. Methodology and Organization 5.1. Description of the Activities Please, fill in the table with details for each specific activity of your development project proposal. Name of the Activity:Purpose of the Activity:Description and Justification of the Activity:Results:Executor of the Activity: 5.2. Methodology for Implementation of the Development Project Proposal 5.2.1. Communication plan and Publicity in the Implementation of the Development Project Proposal Please, describe how the community will be informed publicly about the project implementation and its outcomes.  5.2.2. Organization and Management Please, describe how the development project will be managed by your organization  5.3. Duration of the Development Project Duration of the Development Project(days/months)Planned Start of the Implementation of the Development Project (day/month/year) Planned end of the Implementation of the Development Project (day/month/year)  5.4. Monitoring and Internal Evaluation when Implementing the Activities Please, describe briefly who and how will perform the internal monitoring and performance evaluation of the activity.  5.5. Performance Indicators RESULT INDICATORS Indicator Quantity /pcs/ ... 5.6. Indicators for Evaluation of the Development Project 5.7. Sustainability of the Development Project 6. There are no circumstances under Art. 23, para. 3-8 of Decree No. 234 of the Council of Ministers of 01.08.2011 on the policy of the Republic of Bulgaria on participation in international development cooperation. 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