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Name of the applicant organisationTitle of the programme/project Summary of key points Please describe the programme/project (max 200 words): year of foundingtype of organisationkey objectives location(s)scale (e.g. local, national, etc.)target audiencepartners/ other organisations involvedTHEMESPlease indicate which theme(s) your programme/project fits into: Sports legacy of Olympic Games and major eventsEmpowering youth Mobilising communities to be activeEMPHASIS ON SPORT/PHYSICAL ACTIVITYPlease describe how the programme/project uses sport/physical activity as a tool to face social issues (max 500 words):VisionPlease describe the long and short-term vision of the programme/project (max 500 words):EVALUATION of the Programme/ Project Please describe how you monitor and evaluate the effectiveness of your project (max 500 words):Please describe the current results of such monitoring and evaluation (max 500 words):INTENDED IMPACT OF GRANT AWARDPlease describe how this grant would be used (max 500 words). Please provide a draft one-page budget:Please describe how this grant would impact your project (max 500 words):MATCH FUNDING OF PROJECTThe IOC encourages applicants to seek match funding for their 2017 project by obtaining a letter of commitment from another organisation to fund their project. If applicable, please provide such letter of commitment.Contact informationPlease provide the following information: Person(s) and organisation responsible for the programme/projectFunction of the personAddress Town, CountryEmail addressTelephoneWebsiteSUPPORTING DOCUMENTATION Please attach the following information: One page draft budgetLetter of commitment for match funding of project (if applicable)Financial reports for the years 2015 and 2016.Any other documentation that you believe is important, such as certificates, awards, press articles, summary of reports, photographs, interviews or videos, etc.APPLICATION DEADLINE: 30 APRIL 2017BY SIGNING THIS DOCUMENT, YOU FULLY AND UNCONDITIONALLY ACCEPT AND AGREE TO ABIDE BY THE TERMS AND CONDITIONS OF THE ATTACHED REGULATIONS GOVERNING THE “SPORT AND ACTIVE SOCIETY COMMISSION DEVELOPMENT GRANT”________________________________________________________________DATENAME OF THE APPLICANT SIGNATURE ................
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