Name of the organisation:    

Address:                            

Pin Code:                         

Phone:                             

Fax:                          

E-mail:                      

Website Address:       

Year of registration and name of the registration Act

Head of the organisation:     Mr. / Ms.                     

Contact Person:

Phone no:         

Mobile no.:        

• No. of full time staff:  
• No. of part-time staff:
• No. of Consultants:    
• No. of Volunteers:     

1. No. of years organization has been working with the community:
2. No. of child beneficiaries:

Target Groups (tick all that are appropriate)

Others (please specify)……………

1. Organisation Profile

17.a. Background         

17.b. Area of Work       

17.c. Main Activities     

17.d. Source of funding

Finance / Governance

      18.a. Does your organisation follow any systematic procedure for finance handling?

            Yes                      No

      18.b. Does your organiation believe in strong governance?

            Yes                      No

18.c. Does your organization have audited financial statement for the last three years?


            Yes                    No

1. Monitoring and Evaluation

19.a. Do you pro-actively monitor your activities/ projects?

         Yes     

         No      

1. Information Regarding the Proposed Project

20.a. Title of the project:

20.b. Target

        Group  

20.c. Geographical location of the proposed project:

20.d. Project objectives                                         

      20.e. Project   Budget                                      

20.f. Desired outcome of the project:                      

Kindly submit the filled-up forms at the following E-mai ID : projects@smilefoundationindia.org