PROJECT APPLICATION FORM

FOR
RAINWATER HARVESTING SCHEME

DATE OF RECEIPT:
REF PROJECT ID:
(For Ministry Use Only)

PROJECT/PROGRAMME PROPOSAL
PART I: PROJECT INFORMATION
Name of Applicant:
Postal Address:

Contact Person:
Position:
Telephone No.:
Fax No.:
E-mail Address:
Current Water Bill:
Submission Date:

Web Address:
Telephone No.:
Fax No.:

Name of project:
Project Timeframe. Start (Month/Day/Year):
Project Timeframe. End (Month/Day/Year):

Amount requested (in Rupees): Rs

Total Project Cost (in Rupees): Rs
Fund requested (in Rupees):
Co-Financing Amount (if any):
Total Project Cost (in Rupees):
Rs
Rs
Rs
Implementing Entity
Beneficiary(ies) / Target(s)of the project: Which communities, groups or individuals will the project
benefit? What are the environmental benefits you anticipate and how do you plan to measure them?

Please specify the Organization

Schools (Public and Private)
NGOs
Local Authorities (Markets and Fairs)
Government Agencies

ORGANIZATIONAL BACAKGROUND:
Provide brief summary of organization history, including the date your organization was established

Brief summary of organization mission and goals

Brief description of organizations current program or activities, including any service statistics
andstrengths or accomplishments. Please highlight new or different activities, if any, for your
organization

PROJECT BACKGROUND AND CONTEXT:

Provide brief information on the problem the proposed project/programme is aiming to solve. Outline the
economic social, development and environmental context in which the project would operate.
What is your baseline current water usage?
Monthly or Annual reduction in water usage (m3) due to the proposed investment in rainwater harvesting
system.

PROJECT / PROGRAMME OBJECTIVES:

List the main objectives of the project.

PROJECT WORKPLAN AND IMPLEMENTATION SCHEDULE

This section should provide a work plan for the implementation of the project and the implementation
schedule

MILESTONES
Indicate the dates of the milestones for the project
MILESTONES

EXPECTED DATES

PROJECT BUDGET
This section should provide a statement of the total cost of the project, a detailed cost breakdown, the
amount of fund requested from the Ministry of Environment, Sustainable Development, and Disaster and
Beach Management, how these funds are to be used and the amount, status and sources of additional
funding, if any.

Name & Signature

Implementing Entity Coordinator
Date: (Month, Day, Year)

Tel. and email:

Project Contact Person:

Tel. And Email:

Post Monitoring
For Ministry use only