Request for Aid (Microcredit / Startup / Community) Submit a request for aid for a startup company, microcredit for a company, or a project benefiting the community. For requests for aid for personal projects, use this form. Submit an Aid Request (Microcredit / Startup / Community) Form Defaults Create an account to enable saving this form Name of Project * Your Name * Your email * Your role Project Country * Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonarie(Antille Olandesi) Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Brazzaville Congo DR Cooks Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d‘Ivoire Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadalupe Guam Guatemala Guinea Guinea Conakry Guinea-Bissau Guyana - English Guyana - French Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinica Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caldonia New Zealand Nicaragua Niger Nigeria North Korea North Sudan Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Island Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis – Futuna Yemen Zambia Zimbabwe The local Commission is: Andina Zone Andina Zone Andina Zone Austria Baltic Countries Baltic Countries Baltic Countries Bangkok Bangkok Bangkok Bangkok Bangkok Belgium Belgium Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil - Mariapolis Ginetta Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil Central Brazil North Brazil North Brazil North Brazil North Brazil North Brazil North Brazil North Brazil North Brazil North Brazil North Brazil North Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil Northeast Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil South Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Brazil Southeast Canada Canada Central Africa Central Africa Central Africa Central Africa Central Africa Central Africa Congo Congo Czech Republic East Africa East Africa East Africa East Africa East Africa East Africa East Africa East Africa East Africa East Africa Egypt Egypt France France France Germany Great Britain Hispanic America 1 Hispanic America 1 Hispanic America 1 Hispanic America 1 Hispanic America 1 Hispanic America 1 Hispanic America 1 Hispanic America 1 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Hispanic America 2 Holland - Nordic Countries Holland - Nordic Countries Holland - Nordic Countries Holland - Nordic Countries Holland - Nordic Countries Holland - Nordic Countries Holland - Nordic Countries Hong Kong Hong Kong Hong Kong Hong Kong Hungary India India India India India India Indonesia Indonesia Indonesia Indonesia Ireland Italy Bologna Italy Bologna Italy Bologna Italy Bologna Italy Catania Italy Florence Italy Florence Italy Florence Italy Naples Italy North West Italy North West Italy Polo Lionello Italy Rome Italy Rome Italy Rome Italy Rome Italy Trent Italy Trent Japan Jerusalem Jerusalem Jordan Jordan Jordan Korea Korea Korea Lebanon Lebanon Lebanon Lebanon Lebanon Lebanon Lebanon Lebanon Madagascar Madagascar Madagascar Madagascar Maghreb Maghreb Maghreb Maghreb Manila Nigeria Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Oceania Pakistan Pakistan Poland Poland Portugal Russia Russia Russia Russia Russia Russia Russia Russia Russia Slovakia Slovakia Slovenia Slovenia South Eastern Europe South Eastern Europe South Eastern Europe South Eastern Europe South Eastern Europe South Eastern Europe South Eastern Europe Southern Africa Southern Africa Southern Africa Southern Africa Southern Africa Southern Africa Southern Africa Southern Africa Southern Africa Southern Africa Southern Africa Southern Cone Southern Cone Southern Cone Southern Cone Spain Spain Spain Switzerland Switzerland TBD TBD Turkey Turkey Turkey Turkey United States United States United States United States United States United States United States United States West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa West Africa Choose the local currency * Other Australian Dollar (AUD) Brazilian Real (BRL) Canadian Dollar (CAD) Chinese Yuan Renminbi (CNY) Czech Koruna (CZK) Danish Krone (DKK) Euro (EUR) Hong Kong Dollar (HKD) Hungarian Forint (HUF) Indian Rupee (INR) Israeli New Sheqel (ILS) Japanese Yen (JPY) Malagasy ariary (MGA) Malaysian Ringgit (MYR) Mexican Peso (MXN) New Zealand Dollar (NZD) Norwegian Krone (NOK) Philippine Peso (PHP) Polish Zloty (PLN) Pound Sterling (GBP) Russian Ruble (RUB) Singapore Dollar (SGD) Swedish Krona (SEK) Swiss Franc (CHF) Taiwan New Dollar (TWD) Thai Baht (THB) Turkish Lira (TRY) U.S. Dollar (USD) Choose the local currency please submit financial data in local currency Form mode You are editing in REPORT mode. Reporting sections are highlighted in this color. Beneficiaries 1) Beneficiary Date of First Request to EoC * Beneficiary * Group / Association Business Beneficiary Name Beneficiary Email Address Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Expected Beneficiaries # Members (in the family, association, or business) # job places to be created # job places created Expected # of Direct Beneficiaries # people helped Expected # of Indirect Beneficiaries # people helped Evaluation of people helped Needs & Objectives 2) Needs Analysis and Objectives Describe the condition and socio-economic context * Is the project: Start up of a new activity Strengthening/expansion of an existing activity Project Phase Discovery, Assessment, and Planning Start Up (products/services in production but for <1 year) Please provide information which demonstrates the feasibility of the entrepreneurial idea Describe the problems addressed by this project Show action examples Show me the examples Economy - Finding economic-financial assets / Access to credit Human Capital - Professional skills aquisition Relationships - Networking and cooperation with other economic actors Describe the problems addressed by this project Dimension Economy Human Capital Relationships Purpose Executed? Yes No Partial Alternatives Planned Add another problem Remove this problem Activities Activities Planned List in detail all activities, possibly in quantitative terms with verifiable indicators Activity Use of funds Non-financial (complementary or not related to financial support) Reciprocity / active participation Description Deadline Intermediate End of Project Please specify the timeline Expected Result Executed? Yes No Partial Alternatives Planned Add Remove this activity Expenses Budget Please add the expected costs Timeframe Capital Expense Monthly Quarterly Yearly Category Materials Technical Resources Services Human Resources Expense description Funding source Quantity # of months/quarters/years Cost per unit (local currency) Total Cost (local currency) Add another budget entry Remove this budget entry Actual Expenses paid with EoC funds Update each year with reference to the costs paid with EoC Funds Year of Expenses * Category * Materials Technical Resources Services Human Resources Description of Expenses * Cost (local currency) Document Number Total Cost Add another expense entry Remove this expense entry Funding Funding and Contribution Please enter the amounts of funding received or request from each category Source * Local Partners Beneficiaries' Participation Microcredit - EoC Grant - EoC Reciprocity Fund - EoC OtherOther Status * Not yet requested Requested Requested (with this form) Received Amount * (in local currency) Additional information Add another funding entry Remove this funding entry Attachments Attachments Attach any documents that might be helpful Drop a file here or click to upload Choose File Maximum upload size: 25MB File description Add file Remove this file Reason for extension Acceptance * I accept the privacy policy and terms of use of Economy of Communion Business Network (required) reCAPTCHA
