1. (a)Name of the Applicant______________________________________
(Please use capital letters)

(b)Address__________________________________________________

__________________________________________________

Telephone No.__________________Fax No________________________

For Individuals For Institutions
(a)Date of Birth (a) Registration Number & date

(b)Relevant Act under which
registered

(c)Nationality ( c)Type of Organisation
NGO/Educational/Commercial/other
(Please specify)

2. Title of Project_________________________________________________

3. Duration of Project________________________________________
(Please specify commencement and completion dates)

4. Total amount of financial assistance required____________________

5. Mark the area under which your proposal falls

Education Agriculture
History & Culture Science & Technology
Health Training
Development Studies Women’s studies
Area studies Other

6. Please enclose your project proposal covering the following points:

(i) Rationale/Justification of the study/work

(ii) Objective & Methodology

(iii) Anticipated outcome

(iv) Beneficiaries of the Project

(v) Time schedule and detailed budget

7. Name and address of Recommending Institution, if any

8. Have you applied to the Foundation for financial assistance in the previous 3 years? If so, give brief details of same, including both rejected and accepted proposals.

It is hereby confirmed that, if the above proposal is accepted, I/we shall abide by the Foundation’s by-laws and regulations and would submit a report on the project to the Foundation.

Date____________________ _______________________________
Name & Signature of the Applicant

N.B. The Board reserves the right to entertain, accept or reject any proposal.