<p> U.S. EMBASSY DEMOCRACY COMMISSIOM SMALL GRANT PROGRAM APPLICATION FORM</p><p> aSS-s saelCos demokratiis komisiis mcire grantebis programa ganacxadis forma</p><p>DEADLINE: JANUARY 25, 2016, 6 P.M. sabuTebis miReba 2016 w. 25 ianvris 6 sT.mde. APPLICATION CHECKLIST (Incomplete application will not be reviewed) savaldebulo saaplikacio paketi (komisia ar ganixilavs arasrulad warmodgenil saaplikacio pakets)  One copy of the application form in English (Should not exceed 9 pages, 12 Times New Roman) ganacxadis forma inglisur enaze (araumetes 9 gverdisa, Srifti 12 Times New Roman)  Copy of Organization registration document (in Georgian) organizaciis registraciis mowmobis asli (qarTul enaze)  CVs of the Project Team (in English) proeqtSi monawileTa CV/ biografiuli monacemebi ( inglisur enaze)  Recommendation letters 1-3 (in English) sarekomendacio werilebi 1-3; (inglisur enaze, an qarTul enaze Targmanis darTviT. notariuli damowmebis gareSe).  Confirmation letters from donors on matching funds (if applicable) informacia damatebiT safinanso wyaroebze da donorTa Tanxmobis werilebi (Tu aseTi arsebobs)  Information about project partners and partnership agreements (if applicable) damatebiTi informacia proeqtis partniorebze da partnioruli xelSekrulebebi (Tu aseTi arsebobs) </p><p>Please deliver application package to the following address: saaplikacio paketi datoveT aSS-is saelCos misaRebSi Semdeg misamarTze:</p><p> demokratiis komisiis DemCom Small Grant Program mcire grantebis programa Public Affairs Section aSS-s saelCo, sazogadoebasTan U.S. Embassy Tbilisi urTierTobis ganyofileba</p><p>11 George Balanchine Street, jorj balanCinis q.11 Tbilisi 0131, Georgia Tbilisi 0131, saqarTvelo</p><p>SeniSvna: ganacxadis Sevsebis dros waSaleT mocemuli ganmartebebi/instruqciebi qarTul enaze. konsultaciisaTvis daukavSirdiT sofio gegeWkors (2-277-601), an nino gaguas (2-277-628)</p><p>Information About Organization informacia organizaciis Sesaxeb</p><p>Organization name (in Georgian) organizaciis dasaxeleba (qarTul enaze):</p><p>Organization name (in English): organizaciis dasaxeleba (inglisur enaze)</p><p>Organization Representative: Organizaciis warmomadgeneli</p><p>1 Legal address of the organization: organizaciis iuridiuli misamarTi:</p><p>Physical address of the organization: organizaciis fizikuri misamarTi:</p><p>Contact information: Tel/Mobile, E-mail, Web-page: organizaciis sakontaqto informacia: telefoni, mobiluri, el-fosta, veb-gverdi</p><p>Information on registration: informacia organizaciis registraciis Sesaxeb: Date and Place of registration: registraciis TariRi da adgili: Registration number: registraciis nomeri: TAX identification number: sagadasaxados saidentifikacio kodi</p><p>DETAILED INFORMATION dawvrilebiTi informacia proeqtis Sesaxeb Name of project proeqtis saxelwodeba Amount requested moTxovnili Tanxa grantis maqsimaluri Tanxa $ 24,000. Project period proeqtis vadebi proeqtis dawyeba SesaZlebeli iqneba misi Semotanidan 6 TveSi. proeqtis maqsimaluri xangrZlivobaa 1 weli. Executive summary of the project proeqtis reziume mokled-- TiTo winadadebiT-- warmoadgineT proeqtis reziume: mizani, da mosalodneli Sedegebi. aqve miuTiTeT gancxadebaSi aRniSnul romel prioritetul Temas miesadageba Tqveni proeqti. </p><p>Project Goals and Justification proeqtis miznebi da dasabuTeba es nawili proeqtSi yvelaze mniSvnelovan aspeqts warmoadgens. gaiTvaliswineT Semdegi SekiTxvebi: ra mizans emsaxureba proeqti? ratom unda dafinansdes swored Tqveni proeqti? ra mniSvneloba aqvs mis ganxorcielebas da rogor Seuwyobs igi xels demokratiuli Rirebulebebis ganviTarebas? ra konkretuli problemis mogvarebas elodebiT am proeqtis ganxorcielebis Sedegad?</p><p>Detailed Description of the Project and Activities proeqtis detaluri aRwera da RonisZiebebi</p><p>Tanmimdevrulad CamowereT informacia proeqtis etapebze da RonisZiebaTa saxeobebze. magaliTad: mrgvali magida, konferencia, seminarebis cikli, publikaciebi da a.S. aRniSneT TiToeuli RonisZiebis Tema da mizani, xangrZlivoba, miznobrivi jgufebi, maTi SerCevis meTodi, monawileTa raodenoba da kategoriebi. publikaciisaTvis miuTiTeT Temebi, moculoba, tiraJi, perioduloba da gavrcelebis saSualebebi.</p><p>ACTIVITY TIMETABLE RonisZiebebis kalendaruli ganrigi Activity / ZiriTadi I II III IV V VI VII VIII IX X XI XII RonisZiebebis dasaxeleba 2 1 2 3 4 Project beneficiaries miznobrivi jgufebi/benificiarebi</p><p> miuTiTeT proeqtiT gaTvaliswinebuli miznobrivi jgufebi da raodenoba.</p><p>Expected Results mosalodneli Sedegebi </p><p> aRwereT proeqtis mokle da grZelvadiani Sedegebi, moiyvaneT raodenobrivi da ricxobrivi maCveneblebi, daasaxeleT ra konkretuli problema gadaiWreba proeqtis farglebSi.</p><p>Sustainability of Project sicocxlisunarianoba </p><p> aRwereT am proeqtis mdgradi ganviTarebis perspeqtivebi da organizaciis samomavlo gegmebi.</p><p>Logical Framework for Monitoring and Evaluation (see the example below) logikuri CarCo monitoringisa da SefasebisaTvis (nimuSi ixileT qveviT)</p><p>Objectively verifiable indicators Sources and means for Assumptions and obieqturad dadasturebadi verification wyaroebi da risks daSvebebi da indikatorebi dadasturebis saSualeba riskebi Goal: (mizani) gaumjobesebuli inglisuri samizne studentebis %, testis Sedegebi (saboloo da enisa da kompiuteris romlebmac gaaumjobeses testis sawyisi testebis Sedegebis unarebi iZulebiT Sedegebi minimum 20%-iT Sedareba) gadaadgilebuli bavSvebisTvis</p><p>Expected Results: (mosalodneli Sedegebi)</p><p>1. maswavleblebma ganaTlebis praqtikaSi danerges studentebis %, romlebic studentebis kvlevis Sedegebi saministro zRudavs inglusri enisa da asaxeleben swavlebis axal saswavlo kompiuteris swavlebis midgomebs rogorc ,,ukeTess” programaSi da ukeTesi meTodologia da ,,advilad saswavls”. swavlebis meTodologiaSi 2. kompiuteris cvlilebebis Setanas saxelmZRvaneloebi gadacemis damadasturebeli (riski) qarTul enaze studentebis raodenoba, vinc dokumenti xelmisawvdomia miiRo kompiuteris Sesaswavli moswavleTaTvis saxelmZRvaneloebi qarTul enaze</p><p>Activities: (aqtivobebi) Catarebuli treningebis raodenoba; treningebis dRis wesrigi, maswavleblebi 1.1. samizne monawileTa raodenoba angariSebi, monawileTa siebi. gamoxataven maswavlebelTaTvis survils da treningebis Catareba gamoyofen dros ,maswavlebelTa 1.2. inglisuri enis maswavlebelTa raodenoba, saprezentacio masala treningSi swavlebis axali romelTac gaecnoT da gadaecaT monawileobisaTvis meTodologiis gacnoba masalebi swavlebis axal (daSveba) meTodologiaze</p><p>2.1. kompiuteris Sesaswavli naTargmni da gavrcelebuli monitoringisa da progresis Tanamedrove wignebis raodenoba angariSebi dabali xarisxis saxelmZRvaneloebis Targmani (riski) Targmna qarTul enaze da maTi gavrceleba samizne moswavleebs Soris 3 PROJECT BUDGET proeqtis biujeti /$/-- biujeti warmoadgineT aSS-s dolarebSi, laris Sesabamisi kursis miTiTebiT biujetis yvela muxli enda Seesabamebodes proeqtiT gaTvaliswinebul RonisZiebebs da gamarTlebuli unda iyos. magaliTad: kompiuterisa da printeris SeZena mxolod erTi seminamarisaTvis ar aris gamarTlebuli. ar dafinansdeba Semdegi muxlebi:  sxvadasxva da gauTvaliswinebeli xarjebi  premiebi, prizebi, zeimebi da sxva gasarTobi RonisZiebebi  alkoholuri sasmelebi, yvavilebi da musikaluri gaformeba limitirebulia dafinanseba Semdegi muxlebisaTvis:  kvebaze moTxovnili Tanxa ar unda aRematebodes saerTo biujetis 10 procents.  xelfasebi da honorarebi gadaexdebaT mxolod proeqtSi dasaqmebul pirebs, maTi movaleobebisa da samuSao ganakveTis safuZvelze. saxelfaso fondi ar unda aWarbebdes saerTo biujetis 30 procents da unda Seicavdes saSemosavlo gadasaxads.</p><p>Budget details for Project Activities: Item Details of Budget Amount $ U.S. Other donor Budget details muxlis dasaxeleba sacalo Rirebuleba X saerTo Embassy $ sxva biujetis dasabuTeba raodenoba Rirebuleba saelCodan fondidan moTxovnili moTxovnili/ Tanxa miRebuli Tanxa magaliTad: kompiuteri $500 X 5 kompiuteri kompiuteris $2,500 $1,500 $1,000 (tipi, modeli) Semswavleli kursi sastumro 30 monawile X $30 dRe X konferencia $4,500 $4,500 0 monawileebisaTvis 5dRe TbilisSi Temaze..</p><p>TOTAL $7,000 $6,000 $1,000</p><p>Organization’s In-kind Contribution: organizaciis wvlili proeqtSi Item Description ($) muxli Rirebuleba/ raodenoba Tanxa</p><p>IMPLEMENTATION TEAM proeqtis SemsrulebelTa jgufi daasaxeleT proeqtis ZiriTadi Semsruleblebi, maTi Tanamdeboba, movaleobebi da sakontaqto informacia. garda amisa, proeqts unda daurToT am pirTa biografiuli monacemebi.</p><p>Name Position Title and Description Contacts: saxeli, gvari Tanamdeboba da movaleobebi proeqtis farglebSi, proeqtSi mobiluri/el-fosta CarTulobis dro %</p><p>BACKGROUND informacia organizaciis saqmianobis Sesaxeb  mokled aRwereT organizaciis misia da amocanebi  Sesrulebuli proeqtebi, donorebi da dafinansebis raodenoba  mniSvnelovani miRwevebi OTHER USG FUNDING informacia aSS-s mTavrobis (aSS-s saelCo, USAID) sxva grantebis Sesaxeb gisargebliaT Tu ara warsulSi amerikuli dafinansebiT, da amJamad Tu gaqvT ganacxadi gakeTebuli sxva amerikul sagranto programaze</p><p>4</p>