Gustav-Adolf-Werk E.V. (GAW) Phone: 0049-341-490620

No. of project. : . - - - (to be completed by GAW)

Gustav-Adolf-Werk e.V. (GAW) Phone: 0049-341-490620

Diaspora association under the roof of German Protestant Church (EKD) Fax: 0049-341-4906267

Pistorisstraße 6, D-04229 Leipzig Mail:

Submission via the appropriate Church leadership

Application for project support

1. Description of the project: Name:

Type of project:

Construction: new construction ( ) Type of building: church/chapel ( )

(mark one) extension building ( ) (mark two max.) church hall/ parsonage ( )

renovation/restoration ( ) kindergarten, education, ( )

youth center ( )

Other: old people’s home ( )

administrative building ( )

Other:

Promotion of community life and other projects:

Children and youth ( ) training and development ( )

Women`s empowerment ( ) Library / book purchase ( )

Senior citizens ( ) Support for motorization / transportation ( )

Mission or community development ( ) Confidential gift ( )

Other:

2. Applicant:

Name of congregation or organization:

Address:

Authorized representative (with title):

Telephone: Fax: E-Mail:
Homepage:

3. Attachments:

¨ Description of the congregation or institution (date of establishment, development, number of members, activities, minority situation, social and economic circumstances, relationship with other denominations and to the local authority) attachment 1

¨ Description of the project (Why is this project important? What exactly is being planned? Which construction project or initiative requires support? What is the total scope of the project? What object do you hope to achieve? How will the follow up costs be covered?) attachment 2

¨ Documentation (photographs – electronic or originals, no copies – illustrating institutional life, activities, existing buildings, construction plan)

attachment 3

4. Costs and financing plan

Please note: The financing of the project apart from the GAW contribution must be secured in advance!

(1/3 Rule: at least 1/3 is to be contributed by the institution/parish itself, 1/3 by the church

administration or other organizations, maximum 1/3 by the GAW)

Project planning details:

a) (proposed) start date: ......

b) (proposed) completion date: ......

Name of the responsible project architect/engineer/project director: ______

Adress:

Phone: Fax: Mail:

How high are the anticipated operating expenses for the project? ______

How will the operating costs be covered? ______

Cost statement for the project supported by the GAW:

(Please specify: purchase of property, general construction, interior construction etc.)

Type of cost Local currency Euro

......

Totals

Financing

Local currency Euro

a) Resources already in hand

b) Approximation of the work to be done

by members of the congregation

c) additional income

(offerings, donations etc.)

d) loans, mortgages

e) Grants from the church administration

f) Other supporting organizations:

......

g) Total from a – f

h) Level of support being applied from GAW ______

i) Total from g – h

Currency exchange rate used: ......

5. Signature of the applicant (church or other institution):

We confirm that the financial information concerning the costs of the project, the financing and additional financial support from other organizations is complete and in order.

The executive committee of the applicant in its meeting from……………. (date) supported this application for project support and forwarded an application to the church leadership.

...... , ...... 20....

(place) (date)

...... …………………………………..

(1st signature) (2nd signature)

......

Name of the signatory Name of the signatory

......

Ministry or employment title Ministry or employment title

(pastor, finance director or chairperson of the church council) (pastor, finance director or chairperson of church council)

stamp/seal:

6. Signature of church leadership who will forward the application to GAW:

The church leadership has reviewed all cost and financing information provided, including all other support from other organizations for accuracy and completeness. The church leadership gives assurance that they will give evidence for the proper utilization of grant funds as well as for the final report both being provided in due time (including pictures).

Name of the partnering church:......

...... , ...... 20......

(place) (date) (signature)

Name of the signatory: ......

Administrative title of the signatory:......

stamp/seal :

7. Signature of the representative of the diaspora association:

(required for churches holding a diaspora association )

The diaspora association has reviewed all cost and financing information provided, including all other applications for support submitted at other organizations, and gives assurance that they take responsibility for the proper utilization of grant funds as well as for the final report (including pictures).

...... , ...... 20......

(place) (date) (signature)

Name of the signatory: ......

Administrative title of the signatory:......

stamp/seal :

The GAW will make a decision about the application in the fall board meeting of its representatives for the application year. All project support offered by GAW of the Evangelical Church in Germany comes from voluntary contributions. A commitment for the amount of support offered can be issued only after finishing the collection. This application form is understood to be a guide. We ask that all requested information be provided in full. Please attach all supporting documentation on separate pages.

The application and its supporting documentation is to be submitted to the appropriate church leadership with a request for response. The church leadership and/or the diaspora association of the church will forward the application to the GAW.