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Growthpoint Properties Corporate Social Investment funding application form.
KEY FOCUS AREAS
1.
Education:
Early Childhood Development (accredited programmes)
Primary schools (accredited programmes)
Secondary schools (accredited programmes)
Skills development (accredited programmes)
*
2.
SETA accreditation number
(Required.)
SETA accreditation number
SETA accreditation body
*
3.
Please select option below relevant to your programme
(Required.)
Internship
Learnership
Other SETA accredited training
ORGANISATIONAL INFORMATION
4.
Contact information
Name of organisation:
Contact information:
Contact number (work):
Contact number (cell):
Email address:
5.
Physical address
Street address:
Suburb:
Local municipality:
City/Town:
6.
Postal address
Street address/PO Box:
Suburb:
City/Town:
7.
Date of organisations inception:
Month:
Year:
8.
What is your organisation registered as?
Trust
Section 21 company
Voluntary association
Other (please specify)
*
9.
Please complete:
(Required.)
NPO No. (If applicable)
PBO No.
10.
What is your organisation’s vision?
11.
What is your organisation’s mission?
12.
Describe your service:
13.
How do you define success in your organisation?
14.
List some of your organisations major achievements:
15.
What type of work that will be carried out with the funding?
16.
How long will the project carry out (Start and end date of project/programme)?
17.
Who are the primary beneficiaries of your programme?
Children
Women and girls
Youth
Other (please specify)
18.
Who are the primary beneficiaries of your programme?
please insert number of both direct and indirect
Direct beneficiaries
Indirect beneficiaries
Women and girls
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
Children
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
Youth
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
Other
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
19.
What are the programme objectives?
20.
Location of programme roll-out
Eastern Cape
Free State
Mpumalanga
Northern Cape
Limpopo
North West
21.
What are the programme deliverables?
22.
How many beneficiaries did your organisation support in the previous year?
23.
What do you base this number on? (For example, registers, a database and attendees)
CAPACITY
24.
How many staff have been employed in the past three years:
2021
2022
2023
Staff
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
Full time
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
Part time
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
Volunteers
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
-- Select an option --
1-10
10-20
20-30
30-40
40-50
50+
25.
Are you B-BBEE compliant?
Yes
No
SUSTAINABILITY
26.
Identify your organisation’s main sources of income?
Individuals
Foundation
Corporate
Government of South Africa
Multilateral/Bilateral agency
Other (please specify)
27.
What funds are confirmed for the next three years?
28.
Identify previous and current funders:
Year
Amount
Donor
Year
Amount
Donor
Year
Amount
Donor
Year
Amount
Donor
29.
Provide details of any previous funding or material support from Growthpoint Properties:
Year
Amount
Donor
Year
Amount
Donor
Year
Amount
Donor
Year
Amount
Donor
30.
How much funding is requested towards the project/programme?
31.
What will the funds be allocated towards?
32.
Please provide total budget for the organisation:
33.
What other organisational needs does the organisation have (other than monetary)?
MONITORING AND REPORTING
34.
What is the intended impact for the proposed funding? Please also specify the indicators used to monitor the impact.
35.
What is the organisation’s 'Theory of Change'?
36.
What monitoring and evaluation systems and/or processes to you use?
* Complete all sections and provide as much detail as possible.
*Please be advised that if we require any other documentation such as financials, budgets, BEE certificates, etc, we will contact you.
