Youth Nutrition Grant Application Form

Sector

Organization Name

Contact Name

First Last

Contact Title

Legal/administrative structure:

(What is your legal status, state when incorporated, how long in existence, how is the organization governed, number of full-time staff, what measures do you have for keeping grant funds separate from your operating funds)

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Office Phone

Mobile Phone

Email*

Name of Person Responsible for project implementation and administration of funds:

Mission of organization

(1-3 sentences)

Amount

(state whether JA or US Dollars) $

Project Start Date

Project End Date

List dates of prior application for an AFJ Grant

List AFJ grant awarded (year and $ amount)

PROJECT SUMMARY

Title of Project:

Project Summary

(3-5 sentences describing purpose of grant, program, and expected outcomes)

Where will project activities take place?

If you are seeking partial funding from AFJ for a larger project, which will involve funding from other donors, please state whether you have the other funds in place, and whether/how the project will go ahead if other donations are not forthcoming.

Are you applying to the AFJ Discretionary Grants Program for the aspects of the program other than nutrition? (If yes, it is recommended but not required that these applications are filed simultaneously)

Please set out details specifically related to the Youth Nutrition Grant including number of participants, age range of participants, number of meals to be provided and whether you will be purchasing cooked meals, cooking the meals, providing a food package etc.

Describe the need to be addressed by the project. Is there a specific problem which will be addressed, if so, describe the problem, how many people are affected by it, how adverse or critical is the problem to the wider society?

Describe the objectives and activities of the project.

Describe your institutional or other capacity to carry out the objectives above. Who will implement and monitor the project, and how?

Who would benefit from the services and activities provided under this grant? How many people, what ages, where, what demographic, etc.

Do you have any plan to continue the funded activities past the term of the grant? If so, please describe.

Do you have specific measurable goals for the project? How will the benefits of this project be measured in relation to activities, achievement and objectives and possible partnerships? How will you know if the project has been successful? Do you plan to assess the project’s success? If so, how?

What synergies might be realized, e.g., could the project be replicated elsewhere, be repeated the following year, or serve as a model for others? Is there any training aspect of the project?

PROJECT BUDGET

Please download the Budget Sheet, fill it out and upload it here.

Upload your Nutrition budget sheet as a Word Document, Acrobat PDF or Powerpoint.Include number of participants, weeks, meals per week, cost per meal etc. (File size should be smaller than 2MB).

2MB Limit. (File formats: pdf, doc, docx, ppt, pptx)

Accepted file types: pdf, doc, docx, ppt, pptx, Max. file size: 2 MB.

Upload your project budget sheet as a Word Document, Acrobat PDF or Powerpoint.(File size should be smaller than 2MB).

2MB Limit. (File formats: pdf, doc, docx, ppt, pptx)

Accepted file types: pdf, doc, docx, ppt, pptx, Max. file size: 2 MB.

Please provide a copy of your organization’s last two (2) years financial statements.

Upload your file as a Word Document, Acrobat PDF or Powerpoint. (File size should be smaller than 2MB).

Accepted file types: png, jpg, gif, txt, doc, pdf, ppt, pptx, Max. file size: 2 MB.

Please provide a copy of your organization’s Board of Directors/Governing Body including name, position, and contact information.

Upload your file as a Word Document, Acrobat PDF or Powerpoint. (File size should be smaller than 2MB).

Accepted file types: png, jpg, gif, txt, doc, pdf, ppt, pptx, Max. file size: 2 MB.

Please provide a copy of your organization’s certification under the Jamaica Charities Act, 2013.

Upload your file as a Word Document, Acrobat PDF or Powerpoint. (File size should be smaller than 2MB).

Accepted file types: png, jpg, gif, txt, doc, pdf, ppt, pptx, Max. file size: 2 MB.

Please attach pictures of the grant program/recipients, if available (optional).

One or 2 pictures only. (File size should be smaller than 1MB).

Drop files here or

Accepted file types: png, jpg, gif, txt, doc, pdf, Max. file size: 1 MB.

ELECTRONIC SIGNATURE

Name

First Last

Title

Date

Phone

This field is for validation purposes and should be left unchanged.

PROJECT SUMMARY

PROJECT BUDGET

ELECTRONIC SIGNATURE

GET TO KNOW US

GET INVOLVED

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