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organisation

1.2. Physical and postal address

1.3. Telephone

1.4. E-mail

1.5. Organisation’s website

2. Basic information

on the lead applicant 2.1. Date and place of registration and the name of registration authority (attach certificate)

2.2. Total income of the organisation’s latest financial period

2.2.1. Specify the donor funding sources and amounts during the latest financial period (€)

2.2.2. Other income e.g. membership, consultancy or other fees (€)

2.3 Brief description of the governance, oversight and decision making structures and their roles, including duration of their mandate

2.4. Names and titles of the organisation’s authorised signatories

2.5 Period of latest annual narrative and audited financial report (attach)

2.6. Describe the human resources of the organization (attach organogram or similar)

3. Mission and the strategic orientation of the lead applicants work

3.1. Description of the mission and strategic objectives, and previous experience of the lead applicant in the priorities defined in the Call

3.2. List of possible external evaluations (topic, date and link if published)

4. Monitoring, evaluation and reporting

4.1. Describe the monitoring, evaluation and reporting mechanisms and capacity of the lead applicant

5. Basic information on the members of the consortium Please ADD a row below with the same information for each consortium member

5.1.1 Full name of the organisation and its possible acronym

5.1.2 Date and place of registration and the name of registration authority (attach certificate)

5.1.3 Total income of the organisation’s latest financial period

5.1.4. Specify the donor funding sources and amounts of the latest financial period (€)

5.1.5. Description of the mission and strategic objectives, and previous experience of the member in the priorities defined in the Call

5.2.1 Full name of the organisation and its possible acronym

5.2.2. Date and place of registration and the name of registration authority (attach certificate)

5.2.3 Total income of the organisation’s latest financial period

5.2.4. Specify the donor funding sources and amounts of the latest financial period (€)

5.2.5. Description of the mission and strategic objectives, and previous experience of the member in the priorities defined in the Call

5.3.2. Date and place of registration and the name of registration authority (attach certificate)

5.3.3 Total income of the organisation’s latest financial period

5.3.4. Specify the donor funding sources and amounts of the latest financial period (€)

5.3.5. Description of the mission and strategic objectives, and previous experience of the member in the priorities defined in the Call

6. The programme goal, outcome(s) and outputs

6.1. Describe briefly the programme goal, outcome(s) and outputs

6.2. Describe the geographical coverage of the programme

7. The programme contribution to the Finnish Development Cooperation

objectives in Mozambique

7.1. How does the programme contribute to the implementation of Finnish Development Cooperation objectives in Mozambique

7.2. How are the crosscutting objectives of the Finnish development cooperation – gender equality, non- discrimination (with particular attention to the rights and inclusion of persons with disabilities), and climate resilience and low emission development – take n into account in the programme?

8. The programme’s adherence to Human Rights Based Approach (HRBA)

8.1. Describe how HRBA is applied in the programme

9. Applied funding 9.1. The total of applied funding and the proposed budget per consortium member, in euro (€) (attach the multi-year budget)

Obligatory attachments:

1. Programme document (maximum length 15 pages, excluding the annexes mentioned below)  2. Results framework for the Programme 

3. Multi-year budget for the programme, [based on results] specifying the amounts each member manages  4. Indicative work plan for the programme 

5. Risk matrix or equivalent system analysing risks, mitigation strategies and responsibilities 

6. Letter of intent for the collaboration between the consortium members, signed by a representative of each consortium member organization 

7. Copy of the registration certificate of all members of the consortium 

8. From the lead applicant only: the organogram or other description of organizational structure and staff  9. From the lead applicant only: organization´s strategic plan or a similar document that demonstrates its

organizational goals and area of expertise, including its budget and funding sources 

10. From the lead applicant only: a copy of the audit report for the latest financial period  11. From the lead applicant only: the annual plan and budget for the current financial year 

Please, note that any other attachments than those stated above, will not be considered.

Place and date:

Signature:

Name in capitals:

Position: