Annex 6: Concept Paper Form (For Annual Program Statement)

Annex 6: Concept Paper Form (for Annual Program Statement)

1. General Information

Title of the project The title of the project should be short and concise and should be linked to the project objectives and/or activities Target project area The area where the project will be implemented Thematic focus Include the thematic focus of your proposal (election oversight, women’s empowerment, marginalized population rights, good governance and anti-corruption at local and central level, increased citizen oversight, capacity development) Beneficiaries Include direct and indirect beneficiaries. Applicant(s): Name: - Postal Address - Telephone/Fax - E-mail - Webpage Contact person: - Position - E-mail - Telephone Partners in the project: Name: - Postal address - Telephone/Fax - E-mail - Webpage (add rows if more than one partner) Total estimated budget Include the amount in ALL Amount requested from the Accelerated Include the amount in ALL Civic Development and Cooperation Project Total duration of the project Include the duration in months

1 2. Problem statement and implementation plan (max 2/3 page)  Conceptualization of the problem/solution;  Strategic visioning in how to implement the proposed conceptualization;  Outline of the detailed plan showing how the strategic vision will be achieved;  Plans for monitoring and evaluation of the proposed implementation plan;  Plans for public outreach/interaction with the media; and  Proposed periodic reporting on the implementation plan.

3. Description of the target group / beneficiaries (max 1/3 page)  Description of the target group(s) who will benefit from the proposed removal of the problem.  Extent to which the target beneficiaries include girls, women, people with disabilities, LGBT community, Roma, and other marginalized groups.

4. Project impact (max 1/4 page)  How the proposed solution will be objectively measured as it pertains to the success or extent of success in addressing the issue/problem.  The effectiveness of the proposed method(s) to reach out and to engage the targeted beneficiaries in project activities.  The extent to which the project highlights, contributes to, and influences important policy issues, which may be addressed by local, regional, and national policy makers.

5. Collaborative posture (max 1/4 page)  Extent to which the applicant organization plans to foster cooperation among CSOs, government, media, and citizens to better achieve the project goal;  Demonstration of the level of collaboration with other CSOs to implement innovative advocacy, civic engagement, and technology in fulfilling project goals

6. Project sustainability (max 1/4 page)  How the proposed solution(s) will be sustained once the grant funding expires.

7. Management and programmatic capacity (max 1/4 page) - Evidence of the capability to undertake and accomplish the proposed activities and positively strengthen the civic engagement. - Demonstrate the organization’s effectiveness in terms of internal structure, technical capacity, and key personnel, in meeting the goals of the proposed project. - Demonstrate adequate financial management capability also including previous or ongoing experience implementing similar activities.

8. Budget - Include the total amount and the amount requested from the USAID Accelerated Civic Development and Cooperation Project in ALL (use the budget form, Annex 7).