GLOBAL POVERTY ACTION FUND (GPAF) IMPACT WINDOW PROPOSAL FORM – SECTION 1: INFORMATION ABOUT THE APPLICANT Lead organisation name Concern Worldwide UK 1.1 1.2 Main contact person Name: Jane Adisu Position: Head of International Support Email: jane.adisu@concern.net Tel: 0207 8011851 1.3 2nd contact person Name: James Davey Position: Country Director, Tanzania Email: James.davey@concern.net Tel: 255 22 270 0327 1.4 Please use this space to inform of any changes to the applicant organisation or Consortium details provided in your Concept Note SECTION 2: BASIC INFORMATION ABOUT THE PROJECT 2.1 Concept Note Reference No. IMP-02-CN-0923 2.2 Project title Accelerated MDG1 impact by improving Food, Income, and Governance (FIG) in Northwest Tanzania 2.3 Country(ies) where project is to Tanzania be implemented 2.4 Locality(ies)/region(s) within Ngara and Biharamulo districts, Kagera Region, country(ies) Northwest Tanzania 2.5 Duration of grant request (in 36 months) 2.6 Project start date (month and 2012 year) 2.7 Total project budget? In GBP £ 2,822,000 sterling 2.8 Total funding requested from £1,937,185 DFID in GBP sterling and as a % of total project budget 69% 2.9 Year 1 funding requested from £647,987 DFID 2.10 Please specify the % of project Tanzania 100% funds to be spent in each project country 2.11 Total match funding and status (sources of match funding, amounts, and secured or not secured) - Please enter match-funding details in the table below (add rows if necessary)
GLOBAL POVERTY ACTION FUND (GPAF) – IMPACT WINDOW PROPOSAL FORM SECTION 1: INFORMATION ABOUT THE APPLICANT 1.1 Lead organisation name Concern Worldwide UK 1.2 Main contact person Name: Jane Adisu Position: Head of International Support Email: jane.adisu@concern.net Tel: 0207 8011851 1.3 2nd contact person Name: James Davey Position: Country Director, Tanzania Email: James.davey@concern.net Tel: 255 22 270 0327 1.4 Please use this space to inform of any changes to the applicant organisation or Consortium details provided in your Concept Note SECTION 2: BASIC INFORMATION ABOUT THE PROJECT 2.1 Concept Note Reference No. IMP-02-CN-0923 2.2 Project title Accelerated MDG1 impact by improving Food, Income, and Governance (FIG) in Northwest Tanzania 2.3 Country(ies) where project is to be implemented Tanzania 2.4 Locality(ies)/region(s) within country(ies) Ngara and Biharamulo districts, Kagera Region, Northwest Tanzania 2.5 Duration of grant request (in months) 36 2.6 Project start date (month and year) 2012 2.7 Total project budget? In GBP sterling £ 2,822,000 2.8 Total funding requested from DFID in GBP sterling and as a % of total project budget £1,937,185 69% 2.9 Year 1 funding requested from DFID £647,987 2.10 Please specify the % of project funds to be spent in each project country Tanzania 100% 2.11 Total match funding and status (sources of match funding, amounts, and secured or not secured) - Please enter match-funding details in the table below (add rows if necessary)