Application Summary Form for The Nippon Foundation's Overseas Grant

Date / /
Project applications must be submitted for screening every year, even in the case of multi-year projects. So please fill in the

following information on the activities for one year only.

Project Information

Title of project

Please give a concise description of problems and issues the proposed project will address, and

the purpose and goal of the project.

Background and

Purpose of the Project

Please give a concise description of the expected outcome of the project, including specific
numbers where possible. (In itemized form)

Expected Outcome

Please briefly explain the project outline; its contents, location, schedule of activities, targeted

beneficiaries, and how the project will be conducted. (In itemized form)

Project Outline

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 Please briefly explain how the outcome of the project will be disseminated; publication,
Dissemination
media coverage, conference materials etc.

Project Location Village, Town, District, State or Province, Country etc.

Project Budget 　 JPY/US$/Euro Project Time Frame From　　mm/dd//yyyy

(for one year)

Funding Requested to JPY/US$/Euro To mm/dd//yyyy

The Nippon Foundation

Funding from Others JPY/US$/Euro Desired Date of Grant mm/dd/yyyy

Payment

Implementation Schedule

Date Location Activities

Originality, Impact, and Evaluation of the Project

Please fill in the following section in terms of the entire project period, and not just the activities

to be conducted this year.

Innovative and Original

Aspects of the Project

Expected Impact and

2
 Long Term Effect of

the Project

Please explain how you will evaluate the outcome and impact of the project; including the method

of evaluation, objectively verifiable indicators, and data that will be used as a measure of the

project’s success.

Evaluation Methods

and

Means of Verification

Information for Multi-year project only

Project Period Year(s) (from mm/dd/yyyy to mm/dd/yyyy )

Total Project Budget 　 JPY/US$/Euro Funding Requested to JPY/US$/Euro

The Nippon Foundation

Implementation Schedule

Project Activities 1st year 2nd year 3rd year

Project Plan for (2nd) Year (mm/dd/yyyy - mm/dd/yyyy)

　 JPY/US$/Euro Funding Requested to
Project Budget The Nippon Foundation JPY/US$/Euro

Please give a concise description of the expected outcome of the project, including specific

Expected Outcome numbers where possible. (In itemized form)

3
 Please briefly explain the project outline; its contents, location, schedule of activities, targeted

beneficiaries, and how the project will be conducted. (In itemized form)

Project Outline

Project Location

Project Plan for (3rd) Year　(mm/dd/yyyy - mm/dd/yyyy)

　 JPY/US$/Euro Funding Requested to
Project Budget The Nippon Foundation JPY/US$/Euro

Please give a concise description of the expected outcome of the project, including specific

Expected Outcome numbers where possible. (In itemized form)

Please briefly explain the project outline; its contents, location, schedule of activities, targeted

beneficiaries, and how the project will be conducted. (In itemized form)

Project Outline

Project Location

4
Applicant Information

Name of Organization

Name, Title and Post As listed in the organization’s bylaws.

of Representative

As listed in the organization’s bylaws (PO Box is not acceptable).

Headquarter Address
Country:

Mailing Address

(if different from above)

Telephone Number Facsimile Number

E-mail Address Web Site URL

Date of Establishment Annual Expenditure (FY )

Number of Office(s) Number of Staff

Organization If there is more than one office, please stipulate their locations, and the number of staff at

each office.

Please include all countries that your organization is active in. (Not limited to this particular
Program Countries
project)

Please include the organization’s legal and tax status.

Type of Organization

and Institutional Setting

Mission of Organization

Please briefly describe the past activities and accomplishments of the organization.

(In itemized form)

Main Activities and

Major Achievements

5
Contact Information　
Name, Title and Post

of Project Director

PO Box is not acceptable.

Address
Country:

Mailing Address

(if different from above) Country:

Telephone Number Facsimile Number

E-mail Address

6
 Project Budget Form for The Nippon Foundation’s Overseas Grant

Name of Organization:
Project Title:
Project Period:

1. Project Revenues

　 Amount (JPY/US$/Euro)
The Nippon Foundation 　
Other Donors 　
or Funding Sources 　
Total

2. Project Budget

The Nippon Foundation Others

Items
JPY/USD/Euro Local Currency JPY/USD/Euro
Operational Expenses
(direct expenses for the
project)

Administrative Expenses
(staff salaries, staff travel,
office expenses)

Total
Project Total

Rate: 1 JPY/ USD/Euro = as of

*Although it is not mandatory, The Nippon Foundation recommends that applicants follow this format.
*Please provide us with a detailed breakdown of the expenses.

Percentage of The
Nippon Foundation
Funding Requested to Funding of the Total Project
Project Budget The Nippon Foundation Budget
1st year (mm/dd/yyyy)

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2nd year (mm/dd/yyyy)
3rd year (mm/dd/yyyy)
4th year (mm/dd/yyyy)
Total
For multi-year projects, please fill in the following information:

Date:
Financial Officer: