APPLICATION FORM

Please submit the completed and signed form to applications@kios.fi

1. Title of the project/program	

2. Name of the applicant organisation	
	
Name and position of the person responsible for the project/program	
	
Postal and Visit Address	
	
Telephone	E-mail	
		
Homepage	

3. Short project/program summary 
Please describe how the KIOS funded project/program will contribute to the promotion and/or protection of human rights). Maximum 2500 characters, i.e. ¼ page	
	
Project/program duration in months (i.e. KIOS grant time):		
Financial support requested in local currency	Converted to Euro	

4. Documents to be attached to the grant application to KIOS	Yes [X]	No [X]	
The Results Framework of the Project/Program (fill in KIOS form, annex 1)			
Two Written References (for the project/program) (fill in KIOS form, annex 2)			
The Project/Program Budget (annex 3)			
Applicant Organisation’s Annual Budget (annex 4)			
Applicant Organisation’s Statutes (annex 5)			
Applicant Organisation’s Registration Certificate (annex 6)			
Applicant Organisation’s Annual Report (annex 7)			
Applicant Organisation’s Latest Audit Reports (from the two previous years) (annex 8)			
Additional Documents (You may attach any additional documents you consider necessary for your application) (annex 9)			
Please state the reason for not providing one or more of the abovementioned documents (if applicable)	

Date and place	Signature	
		
	Name and position in block letters	

5. Legal status 
•	Describe the legal status of the applicant organisation
•	Attachment: the registration certificate and statutes	

6. History of the applicant organisation, main goals, programs/activities	

7. Structure of the organisation and current number of staff and their duties 
•	Describe the structure of the applicant organisation
•	Name the board members
•	Name the personnel employed and their duties
•	Specify the current number of members, if applicable 
•	Indicate the number of volunteers, if applicable 	

8. Co-operation with other organisations and memberships in other NGOs and/or networks 	

•	9. Previous and current projects/programs of the applicant organisationList the previous and current projects/programs
You may also attach relevant evaluation reports	

10. Sources of income for the organisation, as well as amount received from each source 
•	Previous and current donors: name of the agency, contact person, his/her contact details (email and phone number), amount funded
•	Other sources of income
•	Attachments: latest audited accounts (from the two previous years), the annual budget of the applicant organisation including confirmed and pending funding	

11. Bank and account information 	
Name and address of the bank where the account is held	
	
IBAN (International Bank Account Number)	SWIFT/BIC	
		
Name of the account holder	

12. Project/Program background and baseline analysis
•	Describe the human rights challenge(s) this project/program aims to address
•	Baseline data: analyse the current situation indicating sources of verification/information
•	Describe the capacity gaps of the project/program beneficiaries in relation to the fulfilment of the relevant human rights that the project/program is focusing on 	

13. Stakeholder and beneficiary analysis
•	List the right-holders and duty-bearers and other responsible actors and stakeholders as direct or indirect beneficiaries of the project/program including their approximate number
•	Explain how the beneficiaries were selected and their capacity gaps were identified
•	Describe the involvement of the beneficiaries in the project/program cycle (planning, management, implementation and/or monitoring and evaluation)	

14. Strategic partners in the project/program
•	Name partners you collaborate with during the project cycle and their respective roles
•	Partners can be for example organisations, institutions, networks and/or individuals	

15. Gender analysis of the project / program
•	Explain how the project/program takes into account and/or contributes to gender equality
•	Describe the participation by gender in all phases of the project / program
•	Gender policy of the organisation (attach if any)
•	Please reflect how gender is taken into account in monitoring and evaluation 	

16. Vulnerable and marginalized groups
•	Describe what are the vulnerable and marginalized groups in the project/program area and how you have identified them 
•	How the project/program takes into account people with disabilities and/or contributes to their rights
•	How the project/program takes into account other groups you have identified as vulnerable or marginalized (e.g. indigenous people, sexual and gender minorities) and how it contributed to the fulfilment of their rights
•	How the different vulnerable or marginalized groups are involved in project/program cycle
•	Please reflect also how vulnerable or marginalized groups are taken into account in monitoring and data collection 	

17. Environment and climate sustainability
•	How the project/program takes into account environment and climate sustainability
•	How the different groups that are vulnerable due to the climate change are taken into consideration	

18. Objectives, expected results and underlying assumptions (remember to fill in ANNEX 1.)
•	Long-term objective (impact)
•	Project/Program specific objective(s) (max. 3)
•	Maximum 3 main expected results in relations to specific objectives 
•	Minimum 3 performance indicators that will measure the main expected project/program results
•	Please explain the underlying assumptions: the necessary positive conditions that need to be realized to achieve the expected results and objectives
•	How the baseline data collected is used as a point of reference against which results will be measured or assessed in the future	

19. Project/program activities (remember to fill in ANNEX 1.)
•	List project/program specific objective(s). Under them, name and describe project/program activities to be carried out to achieve the objective(s)
•	Time scale of the project/program (duration, starting date)
•	In addition, you may attach a separate activity plan	

20. Project/program staff
•	List staff members and their responsibilities in the project/program
•	Number of volunteers involved in their project/program and their duties, if applicable	

21. Sustainability
•	Assess sustainability of project/program results
•	Assess organisational and financial sustainability of the applicant	

22. Risk assessment 
•	Main risk(s) for the project/program not to achieve its objectives: assessment of contextual, institutional and operational risks and mitigation strategies (please use the template)	
Risk	Likelihood	Consequence	Mitigation	
Contextual				
Institutional				
Operational				

23. Monitoring and evaluation
•	Include monitoring and evaluation plan
•	You may attach your Monitoring and Evaluation Policy, if applicable	

24. Financial assistance requested from KIOS
•	The amount of funding requested in local currency 
•	Overview of the other sources of funding for the project / program, if applicable. Indicate source and amount, in money or in kind, received/requested.
•	The project /program budget must include self-financing share of a minimum 10 % of the total costs of project/program (in money or in kind). 
•	Attachment: detailed budget of the project/program in local currency	

25. Have you presented this proposal to any other donors? 
If so, please name the donor/s and the outcome of the proposal.	

Please submit completed and signed form to applications@kios.fi