Australian Embassy
Vietnam
Embassy address: 8 Dao Tan Street, Ba Dinh District, Hanoi - Telephone: 831 7755 - Fax: 831 7711

DIRECT AID PROGRAM (DAP) APPLICATION FORM

Please read the DAP Guidelines carefully before filling out this form.


PROJECT SUMMARY AND CONTACT DETAILS

Please complete this Section of the form with as much detail as possible.

PROJECT TITLE: .................................................................................................................................
..................................................................................................................................

PROJECT LOCATION:

..................................      ....................................       ..............................................
Village                                 City                                   Province  

NAME OF THE ORGANISATION PROPOSING THE PROJECT:

....................................................................................................................................

NAME OR NAMES OF PERSONS RESPONSIBLE FOR THE PROJECT:

Contact Person: ..................................................................................................................................
Address: ..............................................................................................................

Postal Code: ...........................................................................................................

Telephone number: .................................................................................................

Fax Number: .............................................................................................................

PROJECT STATUS:..................................................................................................
(New project or continuation of existing project)

TOTAL COST OF PROJECT: ........................................

TOTAL AMOUNT REQUESTED: ........................................

TOTAL AMOUNT OF LOCAL CONTRIBUTION: ........................................

TOTAL AMOUNT OF COUNTERPART FUNDING: ........................................
(eg. by provincial authorities )

NAME OF OTHER CONTRIBUTING FUNDING ORGANISATIONS (if any)

(1) ...........................................................................................................................................
(2) ...........................................................................................................................................
(3) ...........................................................................................................................................
(4) ...........................................................................................................................................

1. LOCALITY OF THE PROJECT

Briefly describe the area, (mountainous, coastal, remote inland, etc), the location of the project (eg. school, town, etc) and any special features including the main source(s) of employment and per capita income











2. STATE THE PROBLEM

Please briefly explain the history of the project, why the funds are needed and how they would contribute to development in your area. (Attach additional pages if more space is necessary.)











3. STATE THE PROPOSED SOLUTION

Please explain what you plan to do to overcome the problem. Include as much detail as possible about the implementation of the project and why you think it will help. (Attach additional pages if more space is necessary.)












4. WHO WILL UNDERTAKE THE PROJECT?

Please explain who would be responsible for managing the project and who would undertake it, including details of how they are qualified to do this work and any previous experience.












5. WHO WILL BENEFIT FROM THE PROJECT?

The project should benefit a particular community or group. Please describe any special characteristics of this community or group, and how the project will help its members.











6. THE TOTAL COST OF THE PROJECT AND THE TOTAL FUNDING SOUGHT FROM THE DAP

(NOTE: DAP GRANT LIMIT IS APPROXIMATELY USD8,000)

Please attach a sample budget and quotations if available. The cost of the Project should be broken down into clearly defined categories such as equipment, labour, materials, transport, etc. Equipment and materials to be purchased should be itemised and individually costed.





7. WHAT CONTRIBUTION, IF ANY, WILL BE PROVIDED BY THE APPLICANTS

(For example, funds, labour or materials )








8. WHAT CONTRIBUTION, IF ANY, WILL BE PROVIDED BY OTHER SOURCES

Please list the names of the contributing organisations and the precise amount each will provide. Attach any letters or documents confirming the contributions from other sources. Please also indicate if other sources have been contacted but not confirmed.








9. APPROXIMATELY HOW LONG WILL THE PROJECT TAKE TO COMPLETE?

 





10. WHO WILL BE RESPONSIBLE FOR LOOKING AFTER THE COMPLETED PROJECT?


ORGANISATION: .....................................................................................................

CONTACT NAME: ....................................................................................................

ADDRESS: ..............................................................................................................

TELEPHONE NUMBER: ..........................................................................

FAX NUMBER: .......................................................................................


11. ADDITIONAL INFORMATION

 Please provide any further information you consider helpful.( Attach additional pages if necessary.)










Note: The DAP Committee would welcome any photographs, maps, sketches that you might be able to include to help explain your project.