1.
Contact details
Name of the organisation:
Name and role of contact person:
Postal Address (& country):
Visiting Address:
Country:
Phone number(s):
E-mail:
Website/ social network (Facebook, Skype):
Why are we asking you all these questions? We receive many applications, and we cannot meet all the
demand. To help us decide which projects to support we need to know as much about you and your plans
as possible. It is nine (9) questions in total, only fully completed questionnaires will be screened.
2. Organisation
2.1 What is the year and date of the founding of your organisation?
What is the legal status of your organisation?
Attach copy of official registration document (obligatory)
2.1.1. Please describe your target groups:
Please add: Photographs of activities/website/newsletter and/or Information leaflet about the
organisation
2.2 What are the organisation’s activities?
State which activities and whether these activities are: Finished, on-going or planned in the future:
Activity Finished Today Want to start
2.3 What tangible results have been achieved by your organisation?
2.4 What is the organisations geographical coverage? (local, regional)
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2.5 What is the management structure of your organisation?
2.6 How many paid Staff does your organisation employ at present?
2.7 How many volunteers work in your organisation at present?
3. Organisational Budget
3.1 How does the organisation finance its activities? Please state an overview in the following way:
define the activities in the column of description and in the column of total the amounts your organisation
has as income from different activities.
Source Description Total amount Total amount
(in local currency) (in Euro’s)
Earnings from What is produced?
production €
In what volumes?
School fees What is the annual fee
income for your school? €
Membership fee What is the annual fee
income for your €
organisation?
Government/ funding Which authority:
€
For which activity:
Local fundraising Specify the local donors:
€
For which activity:
Local fundraising Fundraising activities:
€
For which activity:
International Give names and contact €
donation/gift details of International
donor:
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For which activity:
Others Specify:
€
Total income per year €
Total expenditure per year €
3.2 Please attach a copy of the organizations Financial Report or Financial record over the last year.
(obligatory)
4. Network and references
4.1 Give the name, contact address and e-mail addresses of 3 local or international (preferably at least one
international ) references that can give additional information about your organisation and mention the
relationship of their organisation with yours. Give references from not related persons and
organisations.
Name Name of e-mail relationship Telephone number
organisation
4.2 Is your organisation affiliated to a (non-governmental) network organisation or umbrella organisation?
Or do you co-operate with any other organisation? (Give name, address and aims of this organisation)
Please elaborate your answer.
4.3 Do you apply for tools at any other Organisation?
If yes, please mention which Organisation
4.4 Did you receive tools from another Organisation?
If yes, please mention which Organisation
4.5 How or from whom did you get our address?
5. Project
5.1 For which type of project do you request tools? (More than one option is possible)
put an X in front of the option!
0 Formal education (formal educations means when that the education is registered by the ministry of
education)
0 Non formal education
0 On the job training (in-company)
0 Other namely:
Please add Copy of official registration document
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5.2 Participants of your project (this is the project for which you are now asking machines and tools from
Tools4Change)
Please fill out the table below regarding the participants of your project
All participants Total number
Younger than 18
Older than 18
Total number of participants
How many of them are Men Total number
and Younger than 18
and Older than 18
Total number of men that participate
How many of them are Women Total number
and Younger than 18
and Older than 18
Total number of women that participate
How many of the participants are orphan? Total number
and are Younger than 18
and are Older than 18
Total number of orphans that participate
How many of the participants have special needs Total number
and are Younger than 18
and are Older than 18
Total number of people with special needs that participate
5.3 Please give information about each course.
Name of Training Numbers of Duration of the Type of Numbers of
students training examination teacher per
and/or certificate training
Please send us a copy of the education/training plan or curriculum outline.
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5.4 In which place, region does the project take place?
Is that a rural or an urban environment?
Do you have buildings, owned by the project, or are you renting?
Please send photos, photos are essential for approval of the project!
5.5What will be the impact of the project (the result for the beneficiaries)? Please elaborate your answer
5.6 How many students have completed the training and what are their current activities? Please answer
the following questions:
Number of students that completed a training in the last five years.
After the training what are their activities? Employed? Where? started their own business?
Will the training contribute to improve the working and living position of the students/trainees? If
yes, how?
6. Tools
6.1 What types and quantities of tools does the project already own? Please specify per course
6.2 How and when have these tools been acquired?
6.3 The requested tools are going to be used for:
0 educational purposes
0 employment purposes
0 entrepreneurship purposes
6.4 Which tools are you applying for? Give a detailed list of requested tools in the following way:
Name of training: Numbers of Type of tool(s): Amount Specifications: like
participants/students requested tools: size; voltage;
per training: brand etc.
6.5 What type of power/energy source is available for the tools? What phase and voltage?
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6.6 Who will be the legal owner of the tools?
6.6 Which safety measures have you taken for the storage and maintenance of the tools
7. Transports and Custom Clearing
This question is of utmost importance when screening your request!
Tools4change only pays for tools to be packed and shipped to the nearest harbour of your project, or in the
case of landlocked countries to the nearest big city. It is very important that you find out what the following
charges are because your organisation will be required to pay:
Customs charges
Storage of tools at port, if needed
Clearance charges and the cost of transporting the tools from the nearest harbour (or big
city for landlocked countries) to your organisation
You should find out about these costs by contacting local customs authorities, clearance agents or other
organisations that have experience in importing donated goods from abroad.
7. 1 Does your organisation has experience in clearing donated goods from customs? If yes, please explain
your experience.
7.2 Does your organisation possess an exemption of custom duties? Please explain how you received this
exemption or how you will be able to obtain one.
7.3 How will you handle the custom clearing of donation of tools? will you be able to pay for these costs?
Please also consider possible unofficial or special tariffs for projects like yours!
7.4 How will you arrange the transport from the harbour or in the case of landlocked countries from the
nearest big city to the destination? will you be able to pay for these costs?
7.5 Please give the exact name and address that should be mentioned on the invoice, gift certificate, bill of
lading and on the transport boxes. Give a detailed explanation when this address is different from the
address mentioned in question 1. And: explain clearly whether or not, the name of the contact person
should or should not be mentioned in all documents and on the transport boxes.
8. Additional information
In addition to this tool application form, please enclose as many of the following documents as possible!
Photos are of importance when we screen your request! Photo’s which show your activities and can be
used on social media. (The ideal size is 1,200 pixels wide by 675 pixels tall (or an aspect ratio of 16:9). The
minimum size is 600 pixels wide by 335 pixels)
0 Copy of official registration document
0 Copy of most recent annual report
0 Copy of the exemption of import duties documents
0 Photographs of the organisation/activities/website/newsletter
0 Information leaflet about the organisation
0 Others, namely….
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9. Signature
I declare that the information I have provided in this application form is true and correct. I also agree on the
arrangement that my organisation will be required to pay the following costs regarding:
Customs charges
Storage of tools at port
Clearance charges and the cost of transporting the tools from the nearest harbour (or big
city for landlocked countries) to your organisation
I also commit to report back to Tools4change at least twice a year in writing and with photograph evidence,
about the development and results of the project upon my application being successful.
I agree: Yes/No (type name of responsible person)
Return address:
Stichting Betuwe Wereldwijd/Tools4Change Tel: +31 345515640
Goilberdingerstraat 32 Email: info@[Link]
4101 BP Culemborg [Link]
The Netherlands
