Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698833235323.pdf (Saint Vincent and the Grenadines)
St. Vincent and the Grenadines Tel.

(784) 456-1223/ (784) 456-1111 ext.

404/5.

Fax: (784) 457-2880.
Email: carcipsvg@gov.vc Website: www.carcipsvg.gov.vc PROJECT PROPOSAL FORM COMPANY INFORMATION NAME OF COMPANY TRADE NAME IF DIFFERENT THAN COMPANY NAME COMPANY CONTACT NAME OF BUSINESS INCUBATOR MAILING ADDRESS PHYSICAL ADDRESS TELEPHONE NUMBER FAX NUMBER EMAIL ADDRESS WEBSITE ADDRESS DATE OF COMPANY REGISTRATION YEAR WHICH COMPANY COMMENCED OPERATIONS NUMBER OF EMPLOYEES MALES FEMALES INDUSTRY/SECTOR 1 PROJECT CONCEPT: 1. BUSINESS BACKGROUND (briefly describe the main activity or the core services of your business : 2 2.
FINANCIAL INFORMATION: ANNUAL REVENUE: …………………………………………….

ANNUAL OPERATIONAL COST: ……………………………… 3.

PROJECT DESCRIPTION (describe the activity which you would be undertaking for which you require funding from the CARCIP program) 4.

HOW WOULD THE IMPLEMETATION OF THIS PROJECT IMPACT ON YOUR BUSINESS?

(If you were to implement this project would it mean you would increase sales, increase employment or improve your business in any other way?)

3 5.
3 5.

OUTLINE ANY PROJECT RISKS IDENTIFIED AND OUTLINE HOW THEY COULD BE MITIGATED: 6.

HOW LONG WOULD IT TAKE YOU TO IMPLEMENT THE PROJECT ACTIVITIES?

From: To: 7.

WOULD YOU BE RECEIVING ANY OTHER DONOR FUNDS FOR THE PROJECT BEING UNDERTAKEN?

YES NO 8.

IF YES, BRIEFLY DESCRIBE WHAT SPECIFICALLY ARE THE FUNDS BEING USED FOR AND THE VALUE OF THE FUNDING RECEIVED.

(please attach any correspondence from the donor which outlines the terms and conditions of the grant funds being received) 4 9.
PROJECT BUDGET: (Provide a project breakdown into separate components, and use the template below to list the corresponding cost/spending items.

Please complete the table in EC dollars.

Feel free to remove or add components and items.

The total of column D corresponds to the grant amount requested.)
Unit Cost (a) Quantity Total (b) (c) Covered by CARCIP (d) Covered by the applicant in cash Covered by the applicant in kind (e) (f) Total (d+e+f+g) Covered by third-party partner (if any) (g) COMPONENT 1 Activity A Activity B Activity C COMPONENT 2 Activity A Activity B Activity C COMPONENT 3 Activity A Activity B Activity C (PLEASE ATTACH A FINANCIAL STATEMENT ANALYSIS – HISTORICAL OR PROJECTED) 5 10.
PROJECT IMPLEMENTATION PLAN (Provide a project breakdown into the same Components as the budget table, and use the template above to list the corresponding activities.

Feel free to remove or add components as your project dictates.)

COMPONENTS DESCRIPTION RESULTS TIMELINE (please fill in the dates when the activities will be started and completed COMPONENT 1: Activity A Activity B Activity C COMPONENT 2: Activity A Activity B Activity C COMPONENT 3: Activity A Activity B Activity C 6 11.
SUSTAINABILITY (Please explain how this project would be continued after receiving funds from CARCIP .Use estimates on demand, revenue, profits and markets to support the explanation.)

12. WHO WOULD BE THE PERSON(S) IMPLEMENTING THE PROJECT FOR WHICH THE FUNDS ARE BEING USED?

NAME: …………………………………………………………………………….

POSITION WITHIN THE ORGANISATION: …………………………………… NAME: …………………………………………………………………………….

POSITION WITHIN THE ORGANISATION: …………………………………… NAME: …………………………………………………………………………….
POSITION WITHIN THE ORGANISATION: …………………………………… (Please attach the Curriculum Vitae of the key personnel implementing the project) 7 13.

DECLARATION I declare that, the statements in the Application Form are true and that, if successful, I will abide by the terms and conditions set by CARCIP.

Signature Date FOR OFFICIAL USE ONLY Date received: ……………………………………………………… Reference number: ………………………………………………….

Officer Signature: ………………………………………………….. 8