. . . . . . . . .

P R O J E C T S UM M A RY

B A C K G R O U N D I N F O R M AT I O N

S TAT E M E N T O F N E E D

G OA L S A N D O B J E C T I V E S

The community has additionally identified the following specific goals and objectives in order of priority: 1. First Main Goal

Sub-goal 1 Sub-goal 2

2. Second Main Goal

Sub-goal 1 Sub-goal 2
METHOD

[State how you are going to go about accomplishing your goals.be very specific.]

ACTION PLAN

NO.

TASK

NEEDED MATERIALS

RESPONSIBLE PERSONS

ESTIMATED TIMETABLE

1. 2.

BUDGET

The project budget was prepared in . All of the final totals have been converted to US Dollars (USD) using a conversion of = $1.00.

REQUESTED FUNDS

ITEM

QUANTITY

UNIT COST

TOTAL COST

TOTAL COST USD

TOTAL

Requested Funds are % of the total project cost

COMMUNITY CONTRIBUTION

ITEM

QUANTITY

UNIT COST

TOTAL COST

TOTAL COST USD

TOTAL

Community Contribution is % of the total project cost

M O N I T O R I N G E VA LUAT I O N

S U P P O RT I N G D ATA