Request for Aid (Microcredit / Startup / Community)

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Name of Project *

Your Name *

Your email *

Your role

Project Country *

The local Commission is:

Choose the local currency * Choose the local currency

please submit financial data in local currency

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Beneficiaries

1) Beneficiary

Date of First Request to EoC *

Beneficiary *

Group / Association

Business

Beneficiary Name

Beneficiary Email

Address

City

State/Province

Zip/Postal

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

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

Partial

Alternatives Planned

Add Remove this activity

Expenses

Budget

Please add the expected costs

Timeframe

Capital Expense

Monthly

Quarterly

Yearly

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

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Funding

Attachments

Attach any documents that might be helpful

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Beneficiaries

1) Beneficiary

Expected Beneficiaries

Needs & Objectives

2) Needs Analysis and Objectives

Describe the problems addressed by this project

Describe the problems addressed by this project

Activities

Activities Planned

Expenses

Budget

Actual Expenses paid with EoC funds

Funding

Funding and Contribution

Attachments

Attachments