SMALL GRANTS APPLICATION SUMMARY

FY2018
Public Diplomacy Office of the American Consulate General in Jerusalem

Title of Project:
Applicant/ Organization Name:
Total Amount Requested: Organization’s Contribution:
Duration of Project:
Name of Contact Person:
Has your organization received previous funding from the U.S. government? YES___ NO . If yes,
please choose below:
Public Affairs MEPI USAID Other Please specify:
Local Partner Organizations (if applicable):

Project Summary:

Write 1 paragraph describing the goals of the proposed project

Alumni Component:

Please explain below how this project will involve our USG exchange program alumni (for example, staff
are alumni, you will invite groups like Access English language youth to attend activities and workshops,
using USG alumni expertise as speakers, etc.)

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Activities:

List the proposed activities in a table format by objective

Objective #1:
Activity Description of the Activity
Number
1.

2.
3.
4.
5.
Objective #2:
Activity Description of the Activity
Number
1.
2.
3.
4.
5.
Results expected:

List # of beneficiaries, and 1-2 sentences describing expected results

Budget Summary:
Complete the following table:

Item Amount (USD)

Personnel
Fringe Benefits
Equipment
Travel
Supplies
Contractual
Other Direct Costs
Indirect Costs
Total Amount
Organization Contribution
Funding Requested from the
Public Diplomacy Office

***Please provide a copy of your organization official registration***

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