Application Form – Election 2020 Call

Local Partnership Component

Instructions:

Applicants are advised to fully complete this template. An incomplete application may not be
considered by STAR Ghana.
All applications must be accompanied by scanned copies of the following:
 Copy of Certificate of Registration and Tax Identification Number (TIN)
 Reference letter from the Municipal / District Assembly where you operate
 Reference letter from any donor or NGO you may have previously received funding from
 Audited Account and Financial Statement
o Latest financial statement for organisations which have been in existence for less
than 3 years
o 2017 and 2016 audited accounts for organisations which have been in existence for 3
years and above;
 Bank statements for the past six (6) months);
 Copy of signed Memorandum of Understanding (MoU) or Partnership agreement s with
collaborators or coalition members (where applicable)
 Other relevant documentation to support your application.

It is important to carefully read the application guidelines, available on STAR Ghana’s website:
http://www.star-ghana.org

SECTION 1: APPLICANT INFORMATION

1.1 Name of organisation/network/coalition Codesult Network

/platform

1.2 Is your organisation a /network/coalition No.

/platform

1.3 If your answer to 1.2 above is yes,

a- What is the name of the lead

organisation?

b- Is your coalition/network/platform
formalized by a memorandum of
STAR Ghana Foundation – Election Call 2020l – Small Grants Component Application Form
 understanding or partnership agreement
for this project?

Attach MoU/Agreement where applicable

1.4 If your answer to 1.2 above is NO, how would
you describe your organisation?
Please select
 Community Based Organisation
 Farmer Based Organisation
 Faith Based Organisation
 Local business association
 Youth association
 Other (please specify)

1.5 Date organisation/network/coalition

/platform was formed/established

1.6 Please provide Lead Organisation’s Company

Registration Number and Tax Identification
Number (TIN)

1.7 Please provide list of Coalition members and

their Company Registration Number and Tax
Identification Number (TIN) where applicable

1.8 Has your organisation/network/coalition

/platform ever been blacklisted by any Donor
including the STAR-Ghana programme?
If yes, provide details

1.9 Does your organisation/network/coalition

/platform have any outstanding audit/project
queries from STAR-Ghana or any of its donors?
If yes, provide details

1.10 What are the goals and objectives of your

organization/network/coalition/platform?

1.11 Please provide information on any projects or activities you have implemented in the past in the area
of local or national level elections. (Bolden text)
A B C
Project

Objective

Project implementation start

and end dates
Achievement(s)

Total Cost

STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form

2
 Funder

CONTACT DETAILS

1.12 Address
If the organisation/network/coalition
/platform has multiple offices, please give
details of the head office

1.13 Telephone number (s)

1.14 Email

1.15 Website (where applicable)

KEY CONTACT PERSON(S) (This is the only person that STAR-Ghana will contact about this application)

1.16 Name

1.17 Designation

1.18 Contact address

(if different from above)

1.19 Email

SECTION 2: ADDITIONAL INFORMATION

2.1 Describe, briefly, the resources available

to the organisation/network/coalition
/platform (staffing, premises, equipment,
etc.) for the implementation of this
project.
Please indicate your staff strength or
volunteer strength

2.2 Please provide the details of the staff Name:

member(s) (Finance and Programme Position:
Persons) who will manage the project
Brief role profile:

Name:
Position:
Brief role profile:

STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form

3
SECTION 3: PROJECT SUMMARY
3.1 What is the title of your project
3.2 What is the proposed duration of your
project (in months)?
3.3 What Is the geographical coverage of
your project?
(Please indicate name(s) of district(s),
and give reasons for the selection of
the particular district(s)
3.4 Under which of the following areas
does your project fall? (See Concept
Note for details)
3.5 Is the proposed project building on
any election related intervention you
have implemented in the past?
If yes, please provide details of the
project you are seeking to build on or
replicate
3.6 Will the project build on any ongoing
or previous elections-related project
by other organisations?
If yes, please provide details of the
project(s) you are seeking to build on
or replicate
3.7 What key challenge(s) or issue(s) do
you seek to address through this
project?
STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form
Strengthening the capacity of citizens in selected
MMDAs in the western north region of Ghana
particularly women and youth in creating a peaceful
environment ahead of 2020 elections.
12 months
National, regional, districts
1. Ghana, Western Region, Wassa Amenfi, West
2. Ghana, Western Region, Wassa Amenfi Central
Select the focus area(s)
 Vigilantism and election related violence
 Inclusion and active participation of elections
 Influencing Manifestoes and Issues-based
campaigning
 Other: please specify
Yes
Yes
Election related violence and vigilantism. In
general Ghana has enjoyed stable and deepening
democratic governance through five successive
elections in 2000, 2004, 2008, 2012 and 2016.
However, the country faces isolated cases of
communal based violence conflicts and sporadic
outbreak of violence be it general, bye and intra-
party elections that threatens the peace, security and
stability of the country.
4
3.8 Why did you select these challenges or
issues and why do these challenges
persist in Ghana?
These challenges persist in Ghana because certain
people exhibits;
 Lack of confidence and trust in election
management bodies(e.g. EC, Police)
 Lack of access to knowledge about the political
electioneering processes
 Social and economic exclusion/marginalization
The situation is compounded by the successful
manipulation of young people by political leaders to
initiate or escalate violent actions to support their
own objectives. Some youth groups have also
developed strong ties with political parties and party
big wigs and called themselves vigilante groups. A
study by Adjei (2012) university of Cape Coast study
revealed among other things that inciting comments
from politicians, the use of alcoholic drinks, collision
of opposing political party members during political
rallies and processions, unemployment and poverty
are some of the main predominant factors that
trigger political violence.

3.9 What change(s) does this project seek

to achieve?

3.10 What is the overall aim of your To support initiatives that contribute to peaceful pre-
project? and post – electoral environment in Ghana 2020
presidential and parliamentary elections.

3.11 What are the main objectives of your To build the knowledge and skills of citizens in
proposed project? selected MMDAs in western north region of Ghana
particularly women and youth in conflict mediation,
negotiations, and dialogue to increase their level of
participation in resolving electoral disputes and
peaceful building efforts.

3.12 What strategies will you adopt to

achieve these objectives?

Why did you choose these strategies?

3.13 How will you address issues of gender

equality and social inclusion in your
project?

3.14 What is new or innovative about your By working directly with people who are affected by

STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form

5
 project? the issues to identify issues, provide solution and
implement with them as against relying on general
top down approaches to issues.

3.15 Provide a summary of key activities you will carry out to implement the strategies identified in
3.10 to achieve your objectives
Strategies Activities
1.information gathering and public 1.1: Organize MMDAs level survey (risk and
consultation preventive factors) to better understand electoral
violence in the target MMDAs.
1.2: Share findings though workshops and meetings
with all electoral –related actors and obtain
feedback on possible solutions to prevent violence
1.3:Organize workshop for political actors and
decision makers in the target areas, media, NGOs
and others to establish an effective network to
target vigilantism and election related violence and
conflict and elaborate a sustainable plan of action
2. Awareness raising and advocacy 2.1: Organize media campaign including radio and
television broadcast.
2.2: Organize poster campaigns, distribution of
leaflets, flyers, stickers, etc
3. Capacity building 3.1: Organize 2, 2-days training for 150 duty bearers
involving security personnel, journalists, party
agents and on themes on, peaceful conflict
resolution, tolerance and social cohesion
4. 4.1:

3.16 Which community actors/ government TEXT

actors/CSOs will you work with to
implement your project (e.g. District
assembly, traditional authorities, specific
NGOs/CBOs, media organisations, etc.)?

For each actor you have identified,

please explain why you have selected
them and their roles.

3.17 Who will benefit from your project

Direct Indirect
What are the targets of each group to Men
benefit directly and indirectly? Boys
Women
(please be specific about the number for Girls
each targeted group) PWDs
Other: please specify
Total

3.18 How will you collaborate with relevant

state institutions and agencies to achieve

STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form

6
 the objectives of the project?

3.18 What risks1 do you foresee in the Download and complete the attached risk
implementation of your proposed management plan
project?

How will you address or mitigate these

risks?

SECTION 4: RESULTS

4.1 Please provide project overall outcome, Download and complete

results, outputs and activities by
completing the attached Project
Performance Plan or Results Framework.
(See glossary of terms on the STAR-Ghana
website)

4.2 How will your project contribute to the

overall aim of the Election Call?

SECTION 5: IMPLEMENTATION PLAN/MONITORING, EVALUATION & LESSON LEARNING

5.1 How will the implementation of your

project and achievement of its objectives
be monitored?

5.2 How will the learning from this project be

captured shared within your
organisation/network?

5.3 Which stakeholders or those outside your

project do you intend to share your
learning with?

SECTION 6: PROJECT BUDGET

6.1 Using the budget template provided, Attach the template to your application
please give a detailed budget for this
project.

6.2 What is the total amount of funding

requested from STAR Ghana?

6.3 How much is your contribution?

6.4 How much contribution is expected from

other donors? (if applicable)

1
Risk is an uncertain event or condition that, if it occurs, has an effect on the project objective(s)

STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form

7
 6.5 What is the total project cost?

STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form

8
 SECTION 7: ATTACHMENTS

7.1 Attachments. Please upload all relevant • Certificate of Registration*

attachments • Tax Identification Number (TIN) Certificate*
• Reference letter from the Municipal / District
Assembly*
• Reference letter from any donor or NGO*
• 2016 audited accounts and financial reports
• 2017 audited accounts and financial reports
• Bank statements for the past six (6) months)
• Signed Memorandum of Understanding (MoU)
• Other relevant documentation to support your
application.

DECLARATION BY APPLICANT
I hereby declare that I have checked and verified the information provided herein and all the attached
supporting documents are true in substance and form. I agree that any information found to be untrue will
render the application null and void and subsequently any grant disbursed to my organisation will have to
be refunded.

Name: ____________________________________

Position/Job Title: __________________________________________

Date: ___________________

Signature: _______________

STAR Ghana Foundation – Election Call 2020 – Local Partnership Component Application Form