Application For Non-Profit Organisation Funding - 2011
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15Provincial Administration: Western Cape
Department of Social Development
DSD
APPLICATION FOR NON-PROFIT ORGANISATION FUNDING 2011
R 200 000 OR LESS
Please provide the information required in this application. Respond to all questions and use additional paper if
necessary. For information on the application process, please read Schedule 5, the last page of this form. Where you
are required to provide an attachment, it will be indicated in this form in italics.
NAME OF YOUR ORGANISATION
STREET ADDRESS
POSTAL ADDRESS
Name
Position
Telephone No.
CONTACT DETAILS
Fax No.
E-mail Address
Is this APPLICATION being submitted AS AN
AFFILIATION? (Y/N) If yes, please provide the
name of the affiliated organisation, the contact
person’s name, telephone and email address.
Section
In process
NPO
Affiliatio
21
Trust
of NPO
n to NPO
Please indicate with an X your organisation type
Company
registration
Children and Families
HIV / AIDS
Please indicate with an X in the appropriate
Older Persons
box/es under which of the DSD PROGAMME/S
Persons with Disability
the services that you are applying for funding,
Substance Abuse
fall under. You may indicate more than one box.
Youth
Sustainable Livelihoods
REGION and/or LOCAL OFFICE and/or
MAGISTERIAL DISTRICT and/or area/s of
operation where you will be rendering services
TOTAL AMOUNT of funding you are applying for
NAME AND SIGNATURE OF DSD OFFICIAL
receiving the proposal (include job title)
DATE RECEIVED (ddmmyyyy)
Business Plan for Non-Profit Organisation Funding
Page 1
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