APPLICATION FORM: International Conservation Grants Program
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1 APPLICATION FORM: International Conservation Grants Program Office Use Only ZV Application Reference No: Date Received: / / Zoos Victoria is a not-for-profit zoo-based conservation organisation dedicated to fighting extinction. Our pursuit of tangible conservation outcomes for threatened species includes a major focus on engaging insitu communities in ways that enable them to take action to help wildlife (Zoos Victoria defines an insitu community as a community whereby local people are directly impacted by or directly impact a project). This approach is reflected through our long-standing international conservation partnerships. Engaging and building the capacity of communities to save wildlife is a significant challenge, however Zoos Victoria believes that this approach is essential if we are to secure sustainable longterm conservation outcomes for wildlife. Consequently, the theme for the round of Zoos Victoria s Grants for International Conservation is Wildlife Conservation through Community Engagement. This recognises that engaging people in protecting wildlife, whilst building social capacity, is critical for the conservation of wildlife. Approaches that influence the adoption of conservation sensitive-behaviours within participating insitu communities will be favoured. Accordingly, submitted projects must meet the key criterion of demonstrating measurable benefits to wildlife and people, in order for it to be considered. Preference will be given to projects which focus on species that are in Zoos Victoria s three zoo, or appropriate analogues, e.g. a submitted project may focus on Grevy s Zebra, which is not in the ZV animal collection, but the Plains Zebra is in the ZV collection. Hence, Plains Zebra at ZV is an analogue for a Grevy s Zebra project in Africa. %282%29.pdf Applications for Zoos Victoria 2014 International Conservation Grants are welcomed for projects located anywhere outside Australia, and are open from 1 August to 30 September, Successful applicants will be notified by 31 October 2014 and projects are to be completed by 31 October Successful applicants will be required to provide final project reports by 30 November Points of clarification and completed applications should be addressed to conservationgrants@zoo.org.au PLEASE COMPLETE THE APPLICATION FORM IN ENGLISH. SECTION 1: Project Summary 1. 1 Project Specifics Project Title: Project Location: Country: Specific Locality: Organisation: Organisation Status: Registered charity Business entity Non-profit Other (please specify)
2 1.2 Personnel Details Project Leader/s Name Position/Organisation Telephone *Please add further lines as required. 1.3 Project Organisation Details Name of CEO Website Contact person (if different to above) Number of full and part-time staff 1.4 Funding (in Australian dollars) Total $ sought from ZV: AUD $ Total Project Budget: AUD $ Description of Project (maximum 250 words) Brief bullet points are welcome. 1.5 Describe the location/context of the project, including community context. 1.6 List the key threats to wildlife/conservation that the project targets. 1.7 List the key actions that the project uses to address these threats.
3 1.8 List the expected wildlife conservation scope of the project, i.e. does it impact at a species, population, habitat or ecosystem scale? SECTION 2: Project Details NB: Responses to Section 2 must be limited to 4 pages of a minimum 12 point font. Title Page, budget and additional information are not included in this limit. Brief bullet points are welcome. 2.1 Describe the expected in situ impact/s of the project for wildlife. 2.2 Describe the expected in situ impact/s of the project for the community. 2.3 Describe how the project s wildlife conservation and community outcomes will be measured and evaluated. You may wish to consider short-term (< 1 year) and long-term measurements/indicators of success (> 1 year). 2.4 Summarise the project methodology (survey design and implementation plan) Communications 2.5 How will you share the project outcomes with other organisations and interested parties?
4 Probability of Success 2.6 Summarise the relevant expertise and track record of the Project Leader, project team, and host organisation in delivering conservation outcomes? 2.7 Is successful delivery of the project dependant on other factors, such as additional funding or buy-in/approval from governing bodies? If so, have they been satisfactorily addressed? 2.8 Are there risks to successfully undertaking the project and, if so, how will they be mitigated? 2.9 Will the project outcomes be sustained once a grant from Zoos Victoria has been expended? SECTION 3: Project Budget Please use this budget template, note any funds from other sources, and clearly indicate priority items. A timeline should accompany the budget (see Section 4). Please note: - Budget must be presented in AUD (Australian dollars). - All funds granted by Zoos Victoria must be expended by 31 October Funding from Zoos Victoria will not exceed AUD. 20,000 per project. - If the budget includes salaries, Zoos Victoria will only support these for local/national organisation staff (not expatriate staff). - Salaries must not exceed 40% of the funding requested from Zoos Victoria. Budget Item (add additional lines as necessary) Cost Source of funding (Place * to indicate if funds are secured) Total funding sought from Zoos Victoria (AUD):
5 SECTION 4: Project Timeline Mark the months against the activities you wish to undertake. Activity Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec *Please add further lines as required. SECTION 5: Additional Information NB: This will not count towards the page limit Please attach the following documentation to support your application 1. Curriculum vitae of project leaders (maximum of 2 pages each) 2. Letters of reference, recommendation, collaboration/agreements with other organisations and support from relevant range-state agencies (optional) 3. Copies of permits (if applicable)
6 SECTION 6: APPLICANT DECLARATIONS To be signed by each Project Leader listed I hereby declare that: 1. The qualifications and experience of all personnel to lead this project are appropriate for the activities described in this application. 2. I agree to discuss any proposed changes to the activities and/or personnel described in this application with the nominated Zoos Victoria contact person for this project. 3. I agree to provide a brief six-month progress update to Zoo Victoria by 31 May I agree to submit a final report by 30 November I will provide copies of any reports, theses or publications arising out of the project; and will acknowledge Zoos Victoria s assistance in any such reports and publications. 6. I will provide information and images of this project to promote the initiative upon request. *Please add further lines as required. Successful applicants will be required to provide final project reports by 30 November OFFICE USE ONLY: ZV ENDORSEMENT Endorsement of International Conservation Partnerships Manager Project Leader Notified / / Date of Funds Transferred: / /
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