Proposals form page

About the Organisation

Name of the Organization*

Website*

Legal entity*

Registration no.*

Date of registration*

(DD/MM/YYYY)

DD slash MM slash YYYY

Registered address*

(head office, field offices/centres)

Email id*

Contact no.*

Location*

(state/ districts/ blocks)

LEGAL STATUS OF GRANTEE (YES/NO)

Income Tax 12A*

Yes

Income Tax 80G*

Yes

FCRA*

Yes

Registration certificate*

Yes

Trust Deed/MOA*

Yes

Board resolution/POA*

Yes

GST registration*

Yes

MSME (MCA)*

Yes

CSR certificate (MHRD)*

Yes

Audited statements (3 Years)*

Yes

Social media presence : (If yes, please share the link.)

Facebook

Twitter

Instagram

YouTube

Other

ORGANISATION PROFILE*

(Write a brief description of your organisation, not exceeding more than 500 words.)

ORGANISATION VISION*

ORGANISATION MISSION*

GROWTH JOURNEY OF YOUR ORGANISATION*

(Tell us how you have scaled your project since its inception in 500 words or less.)

FOCUS AREAS *

Healthcare

Environment

Animal Welfare

Livelihoods

Disaster Relief

Education

Other

ORGANISATIONAL EXPERTISE*

(Brief description of key projects undertaken in the chosen area of focus, not exceeding 500 words.)

KEY DONOR(S) INFORMATION (PAST GRANT DETAILS)

List*

Thematic Area

Name of donor

India/Overseas funding

Year

Previous Project

(Submit details of any one project previously executed)

Name of the Initiative*

Approx. value of the grant received (in INR)*

Duration of the project (in months)*

Name of donor*

Total team strength*

Location of implemented project*

Start date (month/year)*

Completion date (month/year)*

Brief Description of the Project*

FINANCIAL INFORMATION ON PREVIOUS PROJECTS

Please provide the total expenditure in previous projects for the last 3 financial years (all figures in INR).

FY 2020-21*

FY 2021-22*

FY 2022-23*

Proposed Program Details

Name of the proposed program*

(In 500 words or less, describe the projects/programs you plan to propose to AHT. We recommend you propose programs in the sectors and geographies of your expertise. You can also apply to AHT for existing projects that you want to scale up.)

Name of the proposed program*

Program objectives*

(List in points below.)

Focus on sustainable development goals (SDGs).*

(Which SDGs will the proposed program help achieve?)

TARGET SEGMENT*

(Identify the beneficiaries who would be directly impacted by the program.)

PROPOSED GEOGRAPHY

Name of state

Name of district

Name of taluk

Pin code

KEY OUTCOMES AND IMPACT*

(List the outcomes and impact that you envision from this program.)

MONITORING & EVALUATION PROCESS*

(How will you measure these outcomes and impact on the project? Please elaborate on the process only, detailed indicators are not required at this stage.)

IMPLEMENTATION*

(Provide details on the implementing organisation and any other organisations carrying out the work, in 500 words or less.)

OTHER DONORS/CONTRIBUTIONS TO THE PROPOSED PROJECT*

(Will you be leveraging funds from community/other corporates/government stakeholders? If yes, please provide details.)

Proposed Budget for the Project

Proposed Cost (in INR)

Capital*

Operational*

Overhead & Admin*

Total*

Percentage of Total Budget

Capital*

Operational*

Overhead & Admin*

Total*

CONTACT INFORMATION

Name of SPOC*

Designation*

Mobile No.*

Email address*

caution*

I hereby declare that the information published above is true, complete, and correct to the best of my knowledge and belief.*

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