2023/2024 CALL FOR APPLICATION

ANNEXURE B1

SUPPLEMENTARY FORM IN SUPPORT OF CONDUIT APPLICATION

PLEASE NOTE:

• A conduit may only apply for one organisation.

• This form must be completed by both the conduit and the assisted organisation.

• The assisted organisation must have been in existence for a period of less than
six months

• Both conduit and assisted organisation must complete an application form. One
business plan (Annexure A) must be attached per application.

• A conduit must submit all mandatory documents as prescribed in the Application

guidelines.

• A conduit must submit a skills transfer/mentorship plan (Annexure B2)

Annexure B1 Supplementary Form in support of conduit application 2023_20

1.
(a) Describe the capacity that your organisation has enabling it to assist the
organisation herein referred to as the “assisted” :
___________________________________________________________________
___________________________________________________________________

(b) Please provide reasons (community needs) why your organisation is assisting this
organisation and the community thereof:

______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

2. What kind of skills need to be developed by the “assisted” organisation to capacitate

them to successfully implement their projects/ programme?

______________________________________________________________________
______________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________________________

3. In summary, please specify the kind of skills transfer and capacity building that will be
provided and the period for this assistance (NB: A skills transfer plan must be attached to
the business plan)

SKILL/ TRAINING TIMEFRAME

Annexure B1 Supplementary Form in support of conduit application 2023_20

4. Give details of how the implementation of the programme will be monitored and how
impact will be measured.
______________________________________________________________________

______________________________________________________________________
______________________________________________________________________
_____

5. If the conduit is going to charge a fee for the skills transfer and capacity building,
please specify the amount and the items charged for. This should not exceed 5% or
R150 000 of the requested budget for the “assisted “organisation.

Amount applied for Items charged Amount charged %

for

Total

7. When will the assisted organisation be able to apply to the NLDTF on their own?
(Please refer to the guidelines regarding the 12 months cooling off period)

______________________________________________________________________

Annexure B1 Supplementary Form in support of conduit application 2023_20

Declaration:

We commit to working together to achieve the objectives of the programme and will
inform the NLC if there is a breach of this agreement.

On behalf of: The Conduit

Main contact person

ID number

Signature

On behalf of: The Assisted Organisation

Main contact person

ID number

Signature

Annexure B1 Supplementary Form in support of conduit application 2023_20