App 3. 11/23.

THE BRITISH-SERBIAN BENEVOLENT TRUST
Britansko-srpski dobrotvorni fond

Application for a grant
Molba za donaciju

1. Details of organization/group/charity applying for grant:
    Podaci organizacije/grupe/dobrotvorne ustanove koja prilaže molbu za donaciju:

Name  Ime: ___________________________ _____________________

Address  Adresa: ___________________________________________________

_________________________________________________________________

2. Contact details of the representative of organization/group/charity applying for grant:
    Podaci predstavnika organizacije/grupe/dobrotvorne ustanove koja prilaže molbu:

Name/surname  Ime/prezime: ___________________________________________

Telephone  Telefon: _____________________ Email  E-pošta: _____________

Position held within the organization: 
Funkcija koju vršite u organizaciji: __________________________________________

3. Outline plan of project:
    Kratak opis vašeg projekta:

______________________________________________________________________

______________________________________________________________________

Please attach to this application form a detailed analysis and timescale of your project.
Molimo da uz molbu priložite i detaljnu analizu kao i vremenski rok projekta.

4. What is the TOTAL cost of your project?
    Kolika je UKUPNA cena projekta?

Please give amount in euros and dinars:
Popunite iznos u evrima i dinarima:

		€   _____________	RSD  _____________________

5. How much grant are you applying for?
    Koliku donaciju tražite?

		€   ______________	RSD   _____________________

6. How much is your organization/group/charity contributing towards the project cost?
Kolika će sredstva vaša organizija/grupa/dobrotvorna ustanova uložiti u projekat?

		€  ______________	RSD   _____________________

7. Are you applying to other organizations for a grant?
    Da li ste ili ćete se prijaviti nekoj drugoj organizaciji za donaciju?

YES   NO  (Please delete as applicable.)       DA  NE  (Nepotrebno precrtati.)

If YES, please give details:  Ako je odgovor DA, molimo dajte sledeće podatke:
Name of organization/group/charity:  Ime organizacije/grupe/dobrotvorne ustanove:
____________________________________________________________________

Amount applied for:  Koliku ste donaciju tražili?  € _______  RSD________________

            If your project does not receive additional funds, could it still go ahead solely with a grant from the Trust?         YES      NO
Ako za vaš projekat ne dobijate dodatna sredstva, da li ga možete realizovati samo sa donacijom od Fonda?      DA    NE 

8. Signature of applicant representing the organization/group/charity:
    Potpis podnosioca molbe koji predstavlja organizaciju/grupu/dobrotvornu ustanovu:

		Signature  Potpis: _______________________________________