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Aku An Angel memberikan hibah kecil untuk membantu kegiatan masyarakat yang inovatif.

Jumlah tersebut tidak luas dan akan dibagi


menjadi paket kecil Rp 1 (satu) Rp. 15 (lima belas) juta per paket.
Proposal dapat diserahkan langsung ke Direktur Program, Viebeke Lengkong (asanasw@indo.net.id), nomor ponsel 081 139 5188. Kriteria
skrining untuk hibah kecil harus mencakup: inovasi, dampak yang luas, urgensi, partisipasi, keberlanjutan dan potensi replikasi ke wilayah
sasaran lain. Bidang kegiatan atau sektor tidak akan dibatasi dan harus terkait dengan pendidikan, kesehatan, lingkungan,
pengembangan kesempatan kerja, seni-budaya, keuangan mikro skala kecil, dll Yang paling penting kegiatan harus memperkenalkan
pendekatan baru yang berlaku untuk perubahan dan atau perbaikan untuk masyarakat sasaran melalui keterlibatan dan pengembangan
masyarakat.
Proposal dapat diajukan oleh organisasi dan kelompok masyarakat (bukan lembaga pemerintah), mis: dengan rekomendasi dari pemimpin
komunitas mereka. Pelamar tidak selalu lembaga hukum. Gunakan format berikut dan saya menyarankan bahwa semua kegiatan harus
ditetapkan secara eksplisit untuk memenuhi syarat untuk kriteria di atas. Silakan memperpanjang informasi Anda jika diperlukan. Pelamar
akan dihubungi segera setelah screening dan verifikasi selesai.
Silahkan hubungi saya secara pribadi jika Anda membutuhkan bantuan, saya sedang menunggu proposal Anda

IAA GRANT APPLICATION FORM Small Grants Program EXECUTIVE SUMMARY (Please type using no more than one page) 1
Date: 2 Name of organization : 3 Contact Person and title : 4 Address : City : Country : Postal Code: 5 Telephone: Fax : Email :
Website : 6 Mission Statement of the applicant organization? 7 Purpose of funding request and how this activity relates to
civic engagement? 8 Target population and number benefiting from the proposed activity? 9 Period this funding request will
cover? 10 Amount of request (details under Activity Income)? 11 If your organization has received previous support from the
IAA, please list the year, amount and describe for what purpose? 12 Authorizing Name of the applicant organizations
Executive Director or board chair : Signature: Tittle : For Office Use Application Number: Date: Received: PURPOSE OF THE
GRANT 13 Describe briefly the need or issue you will address. Include a description of the constituency served (including
number participating) and how they will participate/benefit? 14 How will the proposed activity promote civic engagement for
empowerment? How will the activity enable marginalized citizens to have greater control over local and community level
development activities? 15 List of the activity goal(s) and measurable objective(s)? 16 Is the activity new or ongoing is the
part of the applicant organization? if the activity is ongoing, how will your organization support this activity in the future? 17
Provide a brief timetable for implementation of activity? 18 What other organizations, if any, will be participating in the
activity? Describe their roles? 19 List the names and qualifications of key staff/volunteers responsible for activity

implementation? EVALUATION 20 Please list the specific outcomes of your activity. What assessment methods/strategies will
you use to track and measure outcomes? (e.g. interviews, surveys, focus groups, community feedback, etc)? 21 Describe
briefly what will be different at the end of the grant period? 22 How will the activitys results be used and/or disseminated?
ACTIVITY INCOME 23 Total applicant contribution: a. In kind (describe) : b. Cash : Total : 24 Funding leveraged by applicant
from other donors : (List all sources and give estimated amounts)? Source : Amount : Total : 25 Total requested from the IAA?
26 Total activity income from all sources? BUDGET FOR THE PROPOSED ACTIVITY Please (1) provide the necessary information
for each budget item, and (2) indicated the funding source(s) that will cover the expense. Use as much space as necessary.
All items must be related to the activity. Item Contribution from Applicant Contribution from other Donors Contribution from
the IAA Total Professional fees (list consultants and fees) Travel (specify) Equipment (specify) Supplies, printing, copying,
telephone, fax, postage and delivery (specify) Evaluation (specify) Total Expenses ATTACHMENTS Please attach any
documents related to your proposal, if available.