Eriac

NAME OF THE APPLICANT ORGANISATION(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Year of Establishment(Required)

Legal Registration number(Required)

Scope of activity(Required)

City and Country of Registration(Required)

Relevant website(Required)

CONTACT PERSON

Name of the contact person(Required)

Position of the contact person(Required)

Email address(Required)

Phone number(Required)

DESCRIPTION OF THE ORGANIZATION (max. 500 words)(Required)

Please provide a short presentation of your organisation (mission, key activities, achievements etc.) relevant to the domain covered by the project.

Arts and culture domain: (you can highlight more than one)(Required)

Arts and Culture

Media

Knowledge-production and Education

History and Commemoration

Romanes Language

OPERATIONAL CAPACITY*(Required)

Please provide a description of your relevant competences and previous experiences as well as those of the key staff who will be involved in the project. (max 100 words)

PROJECT DESCRIPTION

Project Title(Required)

Duration of the project(Required)

Project starting date(Required)

Project Summary (150 words)(Required)

Extended description of the project (max. 500 words):(Required)

Necessity and effects: What action needs to be done and which effects do you expect to accomplish? Goals: Which goals do you wish to achieve with your project? How can these achievements be measured? Where do you wish to realize your project? What actions or activities will your project cover? What will be the outputs of your project?

TARGET GROUP(Required)

Who will benefit from your project (you, your family, Roma community, majority society, etc.)? (max. 100 words)

IMPACT AND SUSTAINABILITY(Required)

What impact or change would you like to achieve? How will you try to ensure sustainability and long-term impact? (max. 100 words)

DISSEMINATION AND COMMUNICATION(Required)

How will you ensure visibility of your project (max. 100 words)

FINANCIAL INFORMATION

Which financial trench are you applying for?(Required)

Small Scale Projects in between 5000 – 10.000 EUR

Medium Scale Projects of 15.000 EUR

Large Scale Projects of 20.000 EUR

Amount requested (IN EURO):(Required)

Financial Details(Required)

Bank name, IBAN, SWIFT Code.

REQUIRED DOCUMENTS:

(no more than 10 MB) BUDGET (EXCEL FILE) - Annual Financial Report - Previous Project Management Experience Report, for example but submitting a narrative activity report from the previous year

BUDGET (EXCEL FILE)(Required)

Max. file size: 3 MB.

Annual Financial Report(Required)

Max. file size: 3 MB.

Previous Project Management Experience Report / Narrative activity report from the previous year(Required)

Max. file size: 3 MB.

Please confirm before submitting(Required)

My organisation adheres to EU values and rights and pledges to respect founding principles promoted by ERIAC.

I hereby confirm I am an institutional associate member of ERIAC.

I hereby confirm I have made my contribution to ERIAC (paid my membership fee/contributed in-kind).

I hereby confirm I fulfil the eligibility criteria of this call.

I declare absence of conflict of interest.

GRANT APPLICATION FORM ERIACNET4EU

CONTACT PERSON

PROJECT DESCRIPTION

FINANCIAL INFORMATION

REQUIRED DOCUMENTS: