International Grant Application

International Development Grant Application

Applicant Information
Program Name*
Contact Person*
Official Recipient (check payee)
Mailing Address 1*
Mailing Address 2
City*
State/Province*
Zip Code*
Country*
Contact Phone*
Email Address*
Community Served

Proposal Summary Describe the project you are proposing, indicating how it will help to promote Lamaze’s mission internationally. (Limit to 100 words)

Project Director and Collaborators Identify the project director and project collaborators. Descrive their background, interest in normal birth and involvement in the project. If a collaborator also offers a financial contribution, it should be noted as well. (Limit to 250 words)

Timeline Identify the steps and timeline for the project. Include when the activities will start and conclude. Grants will be awarded in October 2008 and must be used within the 2009 calendar year. (Limit to 250 words)

Outcomes and Impact Describe in concrete terms what you expect to achieve with the proposed project. What outcomes/results do you anticipate? What will be the impact on consumers? collaborators? community? (Limit to 250 words)

Evaluation Measures How will you evaluate the impact and effectiveness of the International initiative in your community? If your proposal is accepted, you will be asked to submit a final report by December 15, 2008 to include the results of your evaluation. (Limit to 250 words)
Prior grant awardees must return this final report before submitting for an additional grant.
Budget
Total budget for proposed project
Amount requested from Lamaze International
Other project funders or revenue sources
Project budget detail, including justification for all requested items. If your proposal is accepted, your final report must include actual expenditures of the grant funds. Small deviations in budgeted expenditures that stay true to the intent of the project are acceptable. Project directors should maintain appropriate files with receipts, invoices, cancelled checks which may be audited.

Current list of organization officers and membership (if applicable) You may include a list of officers and a general description of the membership or a link to a web site with a list of the officers and membership.

Copy of the organization’s bylaws (if applicable) You may include a copy of your bylaws as an attachment to the application or a link to a web site where the bylaws are posted. If you have not established bylaws, please describe the organization mission, structure and decision making process.
- OR -
Bylaws Attachment	File Size: 2500KB Maximum File Types: .doc .xls .ppt .pdf .txt .zip
Promotional Brochure or Supplemental Material Please provide a web site address for the organization, if one is available, and list promotional brochures or other materials that are available upon request.

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