SECTION I: COVER PAGE Requesting Organization:* Please indicate full name of your organization Acronym: Allocation Type: * (Filled by OCHA) Project Title: * CBPF project code: * (Filled by OCHA) External/Organization’s Project code If any Cluster: * Select Cluster/Sector from the Response Plan. For multi-cluster/sector projects, indicate more than one and the percentage of activities for each. For protection projects, please specify the sub-cluster(s)/sector(s). Project Summary: * Please provide a description of the project, including reference to how the differential needs, concerns and priorities of women and girls, men and boys of different ages and disparities such as disabilities will be addressed. Max 2,000 characters. Link with allocation strategy: * For Standard allocation/Call for proposals please describe how the project fits with the Fund’s Strategic Objectives and Cluster/Sector Specific Objectives. For Reserve allocation/rolling basis please provide a justification explaining why the project should abbe considered for funding. Max 4,000 characters OPS Project Code: Fill if applicable. Project Duration (in months): * Maximum duration 12 months. OPS Project Budget: Planned Start Date: * OPS Priority Level: Planned End Date: * Project Budget in US$: * Funding requested from this allocation: Other contributions/Matching funds (if any): Source: US$: Direct Beneficiaries: * Please break down by gender and age. Women > 18 years Men > 18 years Girls < 18 years Boys < 18 years Total Beneficiary type: * Please indicate how many beneficiaries for the following categories. Beneficiary type Women > 18 years Men > 18 years Girls < 18 years Boys < 18 years Total Host communities Internally Displaced People Refugees Other Please specify. Please fill out one line for each Other beneficiary type. Add more rows if needed. Indirect beneficiaries: If applicable, please indicate estimated number of people who could use your service outside of people targeted in this project, e.g. communities accessing clinics, water points, etc. Sub-Grants to Implementing Partners: Please fill out one line for each sub-partner. Add more rows if needed. Partner Name Partner Type Fill out for each type as applicable. If ‘Other’, please specify. Add one row for each partner. Budget in US$ International NGO National NGO Red Cross/Red Crescent Society UN and IOM Government p Other (please specify) Organization focal point – Country Office: * Please provide name, title, email, telephone for an organizational point of contact (s). Name Title Email Phone Organization focal point - HQ: * Please provide name, title, email, telephone for an organizational point of contact(s) – if different from above. Name Title Email Phone SECTION II: BACKGROUND Humanitarian context analysis: * Describe the current humanitarian situation in the specific locations where this project will be implemented. Max 4,000 characters. Needs assessment: * Explain the specific needs of the target group(s), including reference to the different needs of women, girls, boys, and men, and highlight existing and emerging GBV trends e.g. trafficking, sexual violence, domestic violence, barriers to adequate participation by sex and age, and underlying factors Outline existing capacity and gaps. State how the needs assessment was conducted, list any baseline data and explain how the number of beneficiaries has been developed. Indicates references to assessments such as Multi-cluster/sector Initial Rapid Assessments (MIRA). Max 4,000 characters Description Of Beneficiaries: * Describe the beneficiary groups by sex and age, and other diversifying factors such as disabilities, minorities, etc. Explain how they have been identified and targeted. Max 4,000 characters. Grant Request Justification: * Justify why your organization is best placed to deliver this project. Explain the value added by your organization (e.g. geographical presence, specific expertise etc.) Max 4,000 characters. Complementarity: Explain how the project will complement previous or ongoing projects/activities implemented by your organization. Max 4,000characters SECTION III: LOGICAL FRAMEWORK Overall project objective: * Describe the overall objective(s) to be achieved through the project. Max. 4,000 characters. For multi-cluster projects, please fill out one Logical Framework for each cluster Cluster objectives: * Please select one or more objectives from the list of cluster/sector objectives in the Response Plan for the project’s cluster. Indicate one objective per line, adding more rows if needed. Response Plan objectives: * Please indicate the strategic objective linked to the selected cluster/sector objective as defined in the Response Plan. Percentage of activities: * Please indicate the percentage of activities that contribute to each cluster/sector objective indicated. Total must be 100% Outcome 1 Please describe your intended Outcome. For each additional Outcome, you must appropriately fill out corresponding Output, Description, Assumptions and Risks, Activities and Indicators. Please copy and paste the sections below if you have multiple outcomes. Output 1.1 Please describe your Output below. For each Output, you must choose at least one indicator from the list of Cluster indicators of the primary cluster selected. Additional custom indicators may be added. Please copy and paste the sections below if you have multiple outputs. Assumptions and Risks Please describe assumptions, risks and mitigation strategies for this Output Activities Indicators For each Output you must choose at least one standard indicator from the list of Cluster indicators of the primary cluster selected. Additional custom indicators can be added. Please breakdown by age and gender (men, women, boys, girls) when applicable. End cycle beneficiaries Total end cycle target Cluster Indicator description Means of verification Women Men Girls Boys Indicator Indicator Indicator Indicator Indicator SECTION IV: WORK PLAN Work plan * Include a work plan with clear indication of the specific timeline for each activity defined in the Logical Framework. The work plan must be outlined with reference to the quarters of the project year. Activity description Please list activities corresponding to your indicators and as recorded above in the Logical Framework. Year Quarter 1 Quarter 2 Quarter 3 Quarter 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Activity Activity Activity SECTION V: MONITORING AND REPORTING Monitoring & Reporting Plan: * Describe the specific arrangements for monitoring and reporting arrangements progress and achievements of the project, including: - how indicators and sources of verification will allow in a timely and cost-effective manner to collect information that can inform project management and decision-making - role and responsibilities for collecting, recording, reporting, and using information - specify what monitoring tools and technics will be used to collect data on the indicators to monitor the progress towards the results achieved - provide an indication of the frequency data will be collected and if there is already a baseline for the indicators or if a baseline will be collected Ensure key monitoring and reporting activities are included in the project’s workplan Max. 4,000 characters. SECTION VI: CROSS CUTTING ISSUES AND OTHER INFORMATION Accountability to Affected Populations* Describe: - how beneficiaries and affected populations have been and will be involved in the different stages of the project management cycle: needs assessment, project design, implementation. - what mechanisms will be put in place to enable beneficiaries and affected populations to provide feedback and complaints, and how these will feed into management decisions - what mechanisms have been and will be put to ensure adequate information sharing and communication to beneficiaries and affected populations - indicate how you considered the principles of Do No Harm in the proposed project Max. 4,000 characters. Gender Marker Code: * Refer to IASC Gender Marker FAQ for more information. 0 – No signs that gender issues were considered in project design 1 – The project is designed to contribute in some limited way to gender equality ü 2a- The project is designed to contribute significantly to gender equality 2b – The principal purpose of the project is to advance gender equality 3 – Not Specified 4 – No applicable – Only used for very small number of projects such as ‘support services’ Justify the assessed Gender Marker Code * Describe how the project promotes gender equality, and justify the chosen Gender Marker code. Give at least two concrete examples of how gender considerations will be mainstreamed in project implementation, and which project activities promoted gender equality. Max 2,000 characters Environment Marker Of The Project Please mark one option below A: Neutral Impact on environment with NO mitigation A+: Neutral Impact on environment with mitigation or enhancement B: Medium environmental impact with NO mitigation B+: Medium environmental impact with mitigation (sector guidance) C: High environmental impact with NO mitigation C+: High environmental impact with mitigation (ESSA or EIA & CEAP) N/S: Not specified N/A: Not applicable, only used for a small number of services Justify Chosen Environment Marker of the Project Explain how the project meets the chosen Environmental Marker code. Max. 2,000 characters. Protection Mainstreaming Describe how the proposed project mainstreams protection, including: - how you have prioritized the safety and dignity of beneficiaries and considered the principles of Do No Harm in the proposed project. - how the proposed project enables equal and impartial access to assistance and services and the targeting of vulnerable groups and people with specific needs. - what mechanisms will be put in place to support the development of self-protection capacities and assist affected population’s to claim their rights. Max. 4,000 characters Implementation Plan * Describe the implementation plan of the project, including: - which components of the project will be sub-granted to other entities such as NGOs, governmental entities, or contractors. These arrangements should be clearly identify in the budget. - supervision, reporting lines and distribution of labor that the implementing partner will put in place to manage the successful implementation of the project (e.g.: clear definition of management responsibilities, clear arrangements for coordination of implementation across different stakeholders, financial management arrangements, etc.) - coordination of project activities with humanitarian partners, authorities, beneficiary community and other relevant stakeholders to maximize efficiency and impact, avoid duplication, and promote the sustainability of the project achievements Max. 4,000 characters. Coordination with other Organizations in project area* Explain how you will work with other organizations in the implementation of this project and why. Add one row for each organization. Organization name Areas/activities of collaboration and rationale Safety and Security Briefly explain the security situation in the areas where you plan to implement your project, and how your organization will ensure the safety and security of staff. Max. 2,000 characters. Access Explain how your organization is able to operate in, or plans to access the areas where the project will be implemented. Max. 2,000 characters. SECTION VII: LOCATION Project locations: Please list all locations within the country where project activities will take place, For each location please estimate the % of project budget State/District * (Drop-down menu prefilled from GMS) County/Province (Drop-down menu prefilled from GMS) Estimated percentage of budget for each location * Total must be 100% Estimated number of beneficiaries for each location (optional) List activities (prefilled from GMS) Men Women Boys Girls Total