Grant Application Form Please write the application in English. To save your entries and continue later, scroll down and click "Save and Continue Later" Organisation name*Project Title*Project Summary*Organisation description*Organisation websiteDid your organisation receive financial support from the PBNF before?*YesNoIn what year(s) did your organization receive a PBNF grant, and how high was the grant?How does this new application relate to the former financed project(s), including lessons learned? (Please note that no new funding will be provided before a report has been received about the effectiveness of earlier funding):*Project descriptionThe problem*The context*Target group*Expected direct results*Project start- and end datesStart date* Date Format: MM slash DD slash YYYY End date* Date Format: MM slash DD slash YYYY Project locationIf your project is not located in a city, please put here the city closest to your project site.City*Country*Address or description of project location*Description of location's specific nature, biodiversity, socio-economic, and institutional characteristics:*Project detailsProject objective*Project activities*Expected local project results*Importance and expected outcomes towards international nature conservation.*Give indication of the mid- and long term sustainability of the project results, i.e. how will the results be sustained once the PBNF Funding will have been fully used? Please include max. three critical success factors:*Project budgetBudget Currency (EURO / US$)EURO (€)US Dollar ($)Total Project Budget*Total Project Budget*Please upload your specified budget at the end of the formAmount requested from Prince Bernhard Nature Fund (PBNF)*Please indicate in your specified budget which cost items you request from the PBNF. Please mind the maximum grant is €/$ 20.000.Amount requested from Prince Bernhard Nature Fund*To complete the total budget, from which other sources have you requested funds?Contribution SourceAmount (€/$)Already confirmed? Contribution of the proposing organisationIn Cash (€/$)In KindPartners and referencesName and role of local partner-organisation(s) like community-based organisations, local government and private sector:*Name and contact details of reference person 1*Name and contact details of reference person 2*Contact InformationContact person*Function*Telephone number*Email address* Organization banking detailsBank account number*BIC or SWIFT numberIBAN numberUploadsDetailed Budget*Please upload your detailed budget here! Please check that the detailed budget is the total budget. Please indicate in the budget what part/which items you are requesting from PBNF By clicking to Submit this form you agree to the PBNF Privacy Policy as stipulated on https://www.pbnf.nl/privacy-policy/PhoneThis field is for validation purposes and should be left unchanged.
