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    PetroSA Application For Project Funding

    Uploaded by

    Lungisa Dyasi
    This document is an application for project funding from PetroSA Community Affairs. It requests organizational details, operations information, required documents, details about current programs and projects, funding sources, priority areas for requested funding, and additional supporting information. The organization seeks funding to sustain its current work and priority projects in sectors like education, health, job creation, and the environment.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PetroSA Application For Project Funding

    Uploaded by

    Lungisa Dyasi
    2K views12 pages
    This document is an application for project funding from PetroSA Community Affairs. It requests organizational details, operations information, required documents, details about current programs and projects, funding sources, priority areas for requested funding, and additional supporting information. The organization seeks funding to sustain its current work and priority projects in sectors like education, health, job creation, and the environment.

    Original Description:

    Non Profit Organisation funding application form and guide from the South African Petrolrum Agency

    Original Title

    PetroSA Application for Project Funding

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    This document is an application for project funding from PetroSA Community Affairs. It requests organizational details, operations information, required documents, details about current programs and projects, funding sources, priority areas for requested funding, and additional supporting information. The organization seeks funding to sustain its current work and priority projects in sectors like education, health, job creation, and the environment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views12 pages

    PetroSA Application For Project Funding

    Uploaded by

    Lungisa Dyasi
    This document is an application for project funding from PetroSA Community Affairs. It requests organizational details, operations information, required documents, details about current programs and projects, funding sources, priority areas for requested funding, and additional supporting information. The organization seeks funding to sustain its current work and priority projects in sectors like education, health, job creation, and the environment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 12

    APPLICATION FOR PROJECT FUNDING

    Section 1 – Organisational Details

    Organisation
    Name

    Physical
    Address

    Postal
    Address

    Website
    Address

    Telephone
    Number

    Fax
    number

    e-mail
    address

    Contact
    Persons
    (2 names)

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 1 of 12


    Overview of your organisation:
    This should include details about when it was started, location of head office (if
    any), main activities or programmes engaged in and your achievements to date.

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 2 of 12


    Section 2 – Operations

    Board Members / Trustees


    Title Name & Surname ID Number Designation
    Mr,
    Mrs,

    Management Team
    Title Name & Surname ID Number Designation
    Mr,
    Mrs,

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 3 of 12


    Staff Members
    Title Name Permanent Designation
    Mr, Surname Temporary
    Mrs, Qualification Voluntary

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 4 of 12


    Please indicate the sector or sectors where the organisation is active:

    SECTOR Tick SECTOR Tick

    Education Welfare

    Health Environment

    HIV/AIDS SME Development

    Job Creation/Income Generation Cultural/Heritage/Arts

    Other (specify)

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 5 of 12


    Section 3 – Documents Required

    Please attach the following documents

    DOCUMENT YES NO

    Signed copy of your organisations constitution

    A copy of your organisations mission statement

    A copy of your organisations NPO registration certificate

    A copy of your organisations PBO registration detailing your income


    tax status

    A copy of Tax Clearance Certificate

    A copy of your latest annual report


    List of Trust beneficiaries

    List of Board Members

    Banking details typed onto your organisation’s letterhead signed by


    two senior members who have the authority to do so, and stamped
    by your bank

    (kindly note that this does not guarantee that funding will be
    approved)

    A copy of your organisations latest budget showing operating and


    capital expenditure, as well as income from donations, subsidies,
    fees, sales, fundraising or any other source of income

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 6 of 12


    Section 4 – Programmes and Projects

    Programme Name:
    Description:

    Date Started:

    Status (Planned or Currently Active)

    Main Beneficiaries (direct and indirect)

    Number of Beneficiaries

    Areas of operations

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 7 of 12


    Any other information that you deem fit for us to know, including photo’s, newspaper
    clippings etc (If any) :

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 8 of 12


    Section 4 – Programmes and Projects

    How do you sustain your project/s?

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 9 of 12


    When is your financial
    year end?

    Are your financial statements Audited?

    Do you receive any state subsidies?

    If yes, please give details of department dates and amounts received

    Department Amount Date

    Please indicate the top 3 priority areas for which funding is being requested

    1.

    2.

    3.
    Please identify one specific project and motivate why it should be funded, include the
    budget and/or quotations

    Project Name:

    Motivation:

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 10 of


    12
    List of Current Donors

    Name Amount

    Approached/Potential Donors

    Name Amount

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 11 of


    12
    Section 6 – Additional Information

    1. Include any photographs of your work that could be used to better explain or
    motivate your proposal

    2. Include any plans or diagrams that would assist in the evaluation of your proposal

    3. Include any other specific information that has not been requested that may be
    relevant to the proposal

    ___________________________________________________
    NAME OF APPLICANT ON BEHALF OF THE ORGANISATION

    ______________________ ______________________
    SIGNATURE DATE

    APPROVED ORGANISATIONAL STAMP

    or

    SIGNATURES OF TWO SENIOR MEMBERS OTHER THAN THE


    APPLICANT

    Please send completed Application to:


    Attention: Community Affairs Manager
    PetroSA
    Private Bag X5
    Parow
    7499

    PETROSA COMMUNITY AFFAIRS PetroSA CA APPLICATION FOR PROJECT FUNDINGPage 12 of


    12

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