<p>Application form To be completed by the Foundation “Remembrance, Recommendations for Action Responsibility and Future”:</p><p>Deadline 15 July 2016</p><p>Foundation “Remembrance, Responsibility and Future” Ms Christa Meyer Received:...... Lindenstrasse 20-25</p><p>10969 Berlin</p><p>Ref.:...... Email: meyer@stiftung–evz.de </p><p>Funding programme Facing Antisemitism and Antigypsyism</p><p>Project title </p><p>Brief description of the project (max. 10 lines) </p><p>1 Information on the applicant </p><p>Name of the organisation</p><p>Street, post code, city, country</p><p>Tel Fax</p><p>Email Website</p><p>Contact person for the project: (Name, position, telephone/fax and email)</p><p>Legal representative of the organisation: (Name, position, telephone/fax and email)</p><p>The legal representative of the organisation is specified and named in: (e.g. relevant section of the organisation’s statutes, Higher Education Act... Please mark the section in the documents)</p><p>The legal form of the organisation is (e.g. registered association, church, university, regional authority)</p><p>1 2 Presentation of the applicant</p><p>Description of the organisation, tasks, main activities, target groups, aims of the organisation etc.</p><p>Financing, details of annual budget and supporters </p><p>3 Presentation of cooperation partners (please copy this section for each partner)</p><p>Name, address, contact person, position, telephone/fax/email, website</p><p>Self-presentation of the cooperation partner, tasks, main activities, target groups, aims etc.</p><p>4 Expertise, experience and networking details</p><p>Information on the technical expertise and relevant experience for the project applied for: What experience have you gained to date in carrying out research or action into or combating antisemitism and antigypsyism?</p><p>What activities do you plan to conduct in this area in future?</p><p>Has your organisation already carried out similar projects? If yes, did you gain experience that might prove useful for this project? Please describe.</p><p>What experience do you have in drafting recommendations?</p><p>Networking: In what networks does your organisation actively participate? </p><p>5 Project idea</p><p>Planned project term (from ... to ...) including preparation and follow-up</p><p>Summary of the project idea (2 - 3 pages) </p><p>Do you have any further thoughts about the call for applications, and on which aspects would you put special emphasis when carrying out this project? </p><p>Why would you implement this project?</p><p>What organisations and experts are to be included in the project?</p><p>What results do you aim to achieve? What objectives - apart from the ones stated in the call for applications - do you want to achieve?</p><p>2 What criteria will you use to measure the success of the project?</p><p>What are the risks to the project? How will you address/counter these?</p><p>How is the project to be carried out? (plan of activities, time schedule, milestones) </p><p>What contributions and/or additional funding can your organisation provide from its own resources?</p><p>Staff participating in the project and their qualifications</p><p>6 Project financing</p><p>Third-party Applied for from the Total costs Own funds funds Foundation Personnel costs </p><p>Non-personnel costs </p><p>Total</p><p>Notes on the calculations: Please include comprehensible sub-items and calculation methods for each costing line in an Excel annex, and attach this to the application. Please draw up the schedule of costs and financing using the Foundation’s Excel template: </p><p>“Annex 1 Costs and financing plan, provision of own funds”.</p><p>In order to avoid duplicate funding, please supply details of all other applications for project funding that have been submitted or which you plan to submit. Non-compliance with this requirement may lead to the withdrawal of the approval and a demand for the reimbursement of project funding.</p><p>3 7 Annexes</p><p>The annexes marked  must be submitted. If you attach further annexes, please indicate this by ticking the appropriate boxes. If you are applying for funding for personnel and larger purchases, you must attach the annexes listed in the notes to the cost plan. (See specimen forms on the last page of the application form)</p><p>  Costs and financing plan, own funds (with annexes where appropriate)   Annexes to the schedule of costs (e.g. job descriptions, reasons for purchases) (see specimen forms on the last page of the application form)   Copy of the organization statutes or relevant document (please mark the section where the legal representative is named)   Copy of documents specifying the name of the legal representative (e.g register of associations)   Copy of the certificate of charitable status (notice of tax exemption or copy of the last tax inspection/audit documents)   Information (brochures etc.) on the applicant and its partners   Copies of notifications of grant approval from other donors   Certificate of cooperation (if applicable)   Additional information</p><p>Place ______Date ______</p><p>______Signature of legal representative Signature of legal representative </p><p>______(Name in capitals) (Name in capitals)</p><p>4 Annex to cost plan (specimen)</p><p>Details of personnel costs applied for</p><p>No. in Position/function: Tasks or terms of reference; Weekly cost necessary qualifications, if appropriate working time plan in hours ad PC 1</p><p> ad PC 2</p><p> ad PC 3</p><p>...</p><p>Details of planned purchases (Non-recurring expenditures)</p><p>No. in cost Planned purchases Reasoning plan ad NRE* 1 ad NRE 2 ad NRE 3 </p><p>...</p><p>*NRE = Non-recurring expenditures</p><p>5</p>