FORM A 1
Pro Natura Fund (PNF) for Overseas Grant
Application Form A (For System Input)
Information in this application form will be used only for the purpose of judgement, and will not be used for any other purposes. Pro Natura
Foundation Japan, will deal with private information appropriately according to our privacy policy.

1. INFORMATION ABOUT THE APPLICATION

Title should be simple and easy
to understand.

Project title

Conservation of endangered species XXX

Applicationtype☐ New☐ ContinualIf the same project has been accepted and received the PNF grant before, the applicationwill be considered as “continual”.

2. INFORMATION ABOUT THE APPLICANT GROUP
Name (Group)

XXX Conservation GroupIt should be group’s name, not thename of university or organization
where the applicant belongs to.

URL(If youhave)

3. PROJECT REPRESENTATIVE
Name
Birthdate
Position
heldAddress

Surname01/01/1970

Institution/(dd/mm/yyyy)

Organization

NaturaNationality

Department of Biology, ABC University

Professor
Write down either the applicant’s home address or institution’s address.
Choose either→(Home/Institution)

Residency in the project area☐ Yes

Telephone+81-3-1111-1111

e-mail

4.

ProGiven☐ No
Choose either→(Home/Institution)

PNFJ uses e-mail to contact you. Pleaseprovide your accessible address.

TYPE OF PROJECT (Tick the following.)☐Plants☐Insects☐Mammals ☐Fish☐Amphibians and Reptiles☐Others (☐Birds)

Calculate with the latest exchange
rate. Note that the total amountwill be fixed in yen in thisapplication form.

5. OBJECTIVE(s) OF THE PROPOSAL PROJECT（In approximately 200 words.）
This project is focusing on the conservation of endangered species XXX by doing research…
State clearly what this group is going to achieve in this project.

6. AMOUNT OF SUBSIDY (Write the same amount as Expenditure Schedule: ES)
Total (Yen: A in ES)￥999,998

Total (actual currency to use: A×B in ES )32,258 MYR Exchange rate(B in ES)

31/yen7. EXPENDITURE SCHEDULE
Fill in the Excel sheet of Expenditure Schedule (ES). Japanese member will input ES into theapplication system on line.
8. ANNUAL SCHEDULE OF PROJECT AND BUDGET
Schedule of the project
Oct. Submission of the Receipt to the Secretariat of Pro Natura
2024 Foundation Japan
Nov. Field survey

Dec.

Jan.
2025

2Schedule of expendituree.g. $100 (buy a camera)

Buy a camera: MYR1500

If a work takes several months, use ↕ todescribe it. You can change the height ofrow or line. Do not add pages.

Feb.

Mar. Submission of the Interim Report

Apr.

May.

Jun.

Jul.

Aug.

Sep. End of the grant period

Oct.
Nov. Submission of the Final Report and the Account Report.
/Dec. Final Session for the presentation of result held in Tokyo.

Travel from A to B: MYR2000

You don’t need toindicate wholeexpenses.

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5. PROJECT MEMBERS (consists of at least 3 members)
POSITION INTHIS PROJECT

Project
Representative
Accountant(Japanese)

NAME

AFFILIATIONASSIGNED ROLESXXX XXX

XXX Institution

Analysis of XXX

XXX XXX

XXX University

Collect DNA samples

An accountant must be a Japanesemember.

Write about the specialty of project members and the role they play in this project. (Notnecessary to fill in.)
Dr. XXX is a specialist of …..

6. JAPANESE MEMBER(1) Write down the contact information of Japanese member.
Name

Given

SurnameCountry ofMalaysia
Residence

Institution/
Birthdate(dd/mm/yyyy)

Organization

Position
heldAddress

Telephonee-mailChoose either→(Home/Institution)
Choose either→(Home/Institution)

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9. OVERLAPPING APPLICATION FOR OTHER GRANTSPro Natura Fund does not provide grants for the projects that utilize multiple grants for the same
themes and scope of research or activities. If the scope of research or activities of proposal
project is clearly distinct from the one of other grants’ project, this restriction will not beapplied. If you are currently applying for grants from other foundations or public institutions
related to the same overlapping theme and scope, please provide detailed information. If yourapplication for other grants is approved, be sure to notify Pro Natura Foundation.
Detailed information and status of overlapping application for other grants.
Application No.1
Grant program
name

XXX XXX Fund

Grant institution XXX XXX Foundation
nameGrant amount

MYR10,000

Grant
Period01/09/2024~31/10/2025
dd/mm/yyyy ~ dd/mm/yyyy

Grant
Perioddd/mm/yyyy ~ dd/mm/yyyy

Resultnotification
timingApplication No.2
Grant program
nameGrant institution
nameGrant amountResultnotification
timing