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Contact Details
Partner (Organisation / Representative):
Address:
Tel:
Email:
Project Location
Project Description
Finance
Project Budget (Amount required):
Total number of Package:
Implementation Date:
Total number of Beneficiary:
Package Contents
Item Cost per unit Total Cost in local Currency Total Cost in GBP
Bank Transfer details
Full Beneficiary Name:
Full Beneficiary Address:
Swift Code / Bank Identifier Code:
Iban Number / Account Number:
Project Implementation: (who will implement and how)
Selection Process: (how will you select the right people)
Project Goal:
Essential Document Must be provided:
  • An acknowledgement receipt of the payment
  • Financial statement (with receipt)
  • Documentary evidence
Declaration
Name Position Sign Date
Proposal (office use only)
Date:
Proposed By:
Title:
Location:
Budget:
Number of Beneficiary:
Implementation Date:
Approved By (office use only)
Name Position Signature Date
Office use
Project Reference:
Type of Fund:
Type of Transfer:
Transfer To: