CHASE Fund Project Proposal Outline

CHASE Fund Project Proposal Outline

Projects Category: Arts and Culture
BASIC INFORMATION

Individual Applicant, Complete this section
Project Title
Type the name of your project
Date*

MonthDayYear
Date
First Name* Last Name* Street Address Address Line 2 City Area Code* Phone Number* Email*
TRN*
Tax Registration Number
Alternate Contacts
First Name* Last Name* Area Code* Phone Number* Email
First Name Last Name Area Code Phone Number
Email

BASIC INFORMATION

Organization Applicant, Complete this section
Name of Organization
Position
First Name Last Name Street Address Address Line 2 City Area Code Phone Number Area Code Fax Number Email

APPLICANT INFORMATION

Individual Applicant, Complete this section
Provide a Bio:*
Purpose for Application:*
Provide project undertaking experience/ achievements to date. (List major projects undertaken in the past and outline the approach to managing these project(s)):*

APPLICANT INFORMATION

Organization Applicant, Complete this section
Type of Organization and history (registration particulars):*
Number of members/staff:*
Purpose of Organization:*
Legal/Management Structure:*
Major source of Operating Budget:*
Main Achievements of the organization to date and/or describe major projects undertaken in the last five years (List major projects undertaken in the past and outline the approach to managing these projects):*

PROJECT SUMMARY

Organization Applicant, Complete this section
PROJECT CATEGORY (choose one)*

Performing ArtsVisual ArtsLibraries and ArchivesLiterary WorksMuseumsHistoric Sites and MonumentsHeritageCraftMedia, Film, Music
Project Background/Description (State the why, what, and how of your project):*
Project Site Address:*
Purpose of Requested Funding (Briefly state what the funding is required for):*
Objectives of the project:*

Project Impact (Provide information on the expected benefits of your project):*
Beneficiaries (target group, numbers):*
Outputs and Incomes (expected results of the project)*
Duration (indicate expected start and end dates)*
Management (Explain how project will be managed; give the names and responsibilities of key management personnel):*

Total Project Cost:*
Amount Requested by CHASE:*
Other funding secured (indicate source and amount of funding received or committed):*
Risks and Challenges (State the main risks and challenges to your project meeting its aims and how they will be managed):*

DETAILED IMPLEMENTATION SCHEDULE AND BUDGET

Implementation Schedule (complete using EITHER date or month)
Activity:*
Schedule Type – Date
Schedule Type – Month (Month 1-12)

Project Budget:

List the prices of goods and services required for successful implementation of the project.

	Item Description	Unit Cost ($)	Qty	Total ($)	Requested from CHASE ($)	Equity (Your contributions to the project) ($)	Funding secured or committed by other sources ($)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Total

BASIC INFORMATION