American Academy of Pediatrics



This Word document is a copy of the online ICATCH Preliminary Application. We suggest you use it as a working draft for your answers, so you can check spelling and word counts. You can then cut and paste your answers into the SurveyMonkey Apply online application.IMPORTANT: This Word document is not your application. Please submit your ICATCH Preliminary Application using the online system, at ICATCH Grant Cycle 2019-2012Preliminary ApplicationCountry05430600Project Director First Name019621500Project Director Last Name-9945715000Project Director Email-6639494700Project Co-Director First Name155441333500Project Co-Director Last Nameleft1143000Project Co-Director Email17145773100Person completing this Preliminary ApplicationNameleft825500Emailleft14817600If you are not the Director or Co-Director, please identify where you are, what you do, andyour relationship to the project: (Maximum Word Count 50 words)left502500We have read the Call for ProposalsYesNoPlease indicate the category of your proposalMaternal and infant health (infants under 1 year of age)Childhood injury preventionGender-related health issuesOne sentence summary describing what your project activities will be and where they will3175024638000take place (Maximum Word Count 50 words)Briefly describe your proposalWhat are your goal(s) and specific objectives for this project? What activities will you carry out to meetyour goal and achieve your objectives? Tell us what you want to do and why this is needed; how you willdo it; where the activities will take place and what the community is like; who will carry out the activities;and the approximate time frame and frequency of activities. What outcomes will you assess to measureyour success? Include an estimate of how many children/families/trainees would be involved.(Maximum Word Count 400 words)left571500Have you talked with members of your target community to determine if this project issomething that is needed and that they will support? Please describe briefly. (Maximum Word Count 100 words)left508000Project Director (must live and work near the community where project will take place):Formal education, degree/title (if any); current work done by this person. What specific project activitieswill this person be responsible for? (Do not simply say “will oversee the activities”).(Maximum Word Count 100 words)left538300Project Co-Director (may live outside the community or country, but must be closely involvedwith the project):Formal education, degree/title (if any); current work done by this person; what specific project activitieswill this person be responsible for? (Do not simply say “will oversee the activities” or “will assist theDirector”). (Maximum Word Count 100 words)left151800What will the $2000 per year be used for during each of the 3 years?Please be as specific as possible, include a brief list with approximate costs per activity. Funding cannotbe used for international travel or for Director or Co-Director salaries. (Maximum Word Count 200 words)left568700Names and websites (if applicable) of any partner organizations that will work with yourproject.Please tell us how they will be involved with your project. Please spell out any abbreviations.(Maximum Word Count 100 words)019621500Is there anything else you would like to tell us about your proposal?You may want to mention past successes, why this is very much needed, the difference it will make, etc.We are especially interested in hearing about your plans for sustainability beyond the 3-year grantperiod. This may help us select your proposal to be included among those invited to apply for funding inthe 2019 Grant Cycle. (Maximum Word Count 150 words)left9356500 ................
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