NORTH PACIFIC DEVELOPMENT FUND APPLICATION GUIDELINES

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New Zealand Embassy 733 Bishop Street, Suite 2020 Honolulu, HI 96813 UNITED STATES OF AMERICA Tel: +1 808 675 5555 Fax: + 1 808 675 5561 Email: HLUenquiries@mfat.govt.nz NORTH PACIFIC DEVELOPMENT FUND APPLICATION GUIDELINES This application package provides information on the North Pacific Development Fund (NPDF), which enables the New Zealand Embassy in Honolulu to support activities that contribute to economic development in the Federated States of Micronesia, the Republic of Palau and the Republic of the Marshall Islands. Funds are limited and only the best proposals will receive assistance. The decision of the New Zealand Embassy is final and is not subject to an appeals process. Eligible activities or projects: NPDF is primarily aimed at supporting small-scale development projects or activities. Recipients will normally be non-government organisations and community groups engaged in development activities on a non-profit basis. The maximum grant for a single activity is NZ$75,000. Priority will be given to activities or projects: That enhance gender equality and increase the equitable participation of women in development; That target assistance to the disadvantaged which may include people with disabilities, ethnic minorities, young people and communities in remote areas who have not otherwise received assistance; Where the applicants are making a significant contribution themselves in labour, transport, materials, and/or cash; That encourage and facilitate self-help through active participation of beneficiaries in the identification, design and implementation of the project; Have clearly stated objectives and a sound implementation plan; That employ sound environment and ecological practices; and That have high development impacts in proportion to costs. Activities or items which will not be supported include: Research; Scholarships; Salaries; Payments to consultants or advisers; Motor vehicles, televisions, international travel, animals or other goods/services commonly subject to theft, misuse, conversion, disease or damage; Unsolicited donations to charities, orphanages or other forms of welfare; For profit business enterprises under the control of individuals; Cultural or sporting activities unless the community involved is particularly disadvantaged; Political, religious or evangelical activities. Grants to individuals.

New Zealand Embassy 733 Bishop Street, Suite 2020 Honolulu, HI 96813 UNITED STATES OF AMERICA Tel: +1 808 675 5555 Fax: + 1 808 675 5561 Email: HLUenquiries@mfat.govt.nz Application process All applications should be: Clearly written on the form provided. Additional information can be attached; Supported by invoices/purchase orders from suppliers of goods and services to the activity where relevant; Signed by a responsible member of the applying organisation; and sent to: NPDF Administrator New Zealand Embassy 733 Bishop Street, Suite 2020 Honolulu, HI 96813 or HLUenquiries@mfat.govt.nz ***Applications for assistance will be assessed and a written reply will be sent to all applicants. Except in exceptional circumstances and prior agreement, no cash or cheques will be paid to applicants. Successful applicants will be required to confirm that the goods and/or services were received and were used for the purpose outlined in the application. All activities supported may be subject to monitoring visits by New Zealand representatives. Full cooperation and access to project location must be provided for monitoring visits.

New Zealand Embassy 733 Bishop Street, Suite 2020 Honolulu, HI 96813 UNITED STATES OF AMERICA Tel: +1 808 675 5555 Fax: + 1 808 675 5561 Email: HLUenquiries@mfat.govt.nz Office Use Only Date Received Date Reviewed Outcome NORTH PACIFIC DEVELOPMENT FUND APPLICATION FORM Project Title: 1.1 Organisation Name: 1. INFORMATION ABOUT THE APPLICANT ORGANISATION 1.1.1 Village: District: Island Group: 1.1.2 Contact Person: 1.1.3 Address: 1.1.4 Phone Number(s): 1.1.5 Email Address: 1.2 Organisation Membership Men Women Boys Girls Number 1.3 Organisation Leadership Position Name

1.4 What is the purpose of your organisation and how long has it existed? (Please attach copy of registration document and charter.) 1.5 Other projects the group has received funding for (including from the New Zealand Government) Activity (name and year) Donor Amount 2. INFORMATION ABOUT THE PROJECT 2.1 Project background Consider: How has the project come about? Is it a new or existing project? What needs will it be meeting? Who has been consulted in determining the need for this project? North Pacific Development Fund Application Form

2.2 Project description Consider: Describe the project, including objectives (e.g. increase community awareness of climate change and impacts of flooding) and activities (e.g. 3 community workshops) to be undertaken. 2.3 Project outcomes Consider: What specific outcomes are expected from the project (e.g. 20 women will attend community workshops on climate change and be able to reduce the impact of flooding in their villages)? These outcomes are what you will be expected to report against. How will the organisation monitor progress against outcomes? 2.4 Stakeholder identification and participation Consider: Who is the project aimed at helping (please specify numbers of people, location and socio-economic status)? What groups have been consulted in the development of the project? How will the proposed beneficiaries and other stakeholders be involved in the planning and implementation of the project?

2.5 Gender (if relevant) Consider: Are the interests of different gender groups included in the project? 2.6 Environmental Impact (if relevant) Consider: Will this project adversely affect the environment? If so, what strategies are being undertaken to counter this? 2.7 Time-frame Consider: Over what period will the project operate? Specify the starting date and completion data. Attach a detailed implementation plan and timeline. 2.8 Risks Consider: What risks has your organisation considered? What major problems might affect the project (such as land use, training, technical assistance, equipment, personnel)? How will these risks be managed? Who will be responsible for future costs and maintenance after the project is completed? 2.9 Other similar projects Consider: Are other organisations undertaking a similar project that the target group is able to access? If yes, please detail.

3. BUDGET 3.1 Contributions from your organisation Consider: Cash and in-kind contributions. If contributing cash, please provide a bank statement demonstrating proof of group funds. If you require more space, please attach additional page. Item Value Total contribution from your organisation 3.2 Contributions made by other organisations to the project If you require more space, please attach additional page. Item Organisation Value Total contribution from other organisations 3.3 Budget items requested from the North Pacific Development Fund Provide details of Labour, Materials, Equipment and other items. Please attached itemised quote/invoice for requested items Item Value Total amount requested under NPDF 3.4 Total project budget Items Table 5.1 - Contributions from your organisation Value Table 5.2 - Contributions from other organisations Table 5.3 - Budget items requested from NPDF Total cost of the project 3.5 Additional Budget Information Provide any additional budget information, such as applications for funding that have yet to be confirmed from other organisations for this project.

4. PROJECT RESOURCES AND FINANCING 4.1 Do you have enough land for the project? Yes No Please attach a letter from the land owner granting approval for use of land if required. 4.2 Tools/equipment/materials required Consider: What do you need and how do you propose getting them? 4.3 Who will provide labour for the project? 5. SMALL CONSTRUCTION PROJECT If your project involves small construction work, please provide a simple project design with material cost calculations for the various components of the whole project on a separate sheet. 6. APPLICATION ENDORSEMENT Although not compulsory, letters of support from relevant government agencies, or stakeholders for your project will enhance your application. These should be done on an official letterhead paper or letterhead. 7. FINAL CHECKLIST: Have you: a. Completed all sections of the form correctly and truthfully? b. Enclosed quotations/invoices/purchase orders for the materials or equipment you seek? c. Attached any other required documents (such as letters of support)? d. Signed below? Application submitted by: Name: Title: Signature: Date: