Scribd Logo
Upload

Welcome to Scribd!

  • 28 views

    Berjaya Beneficiary-Application-Form-2024

    Uploaded by

    anisisnin
    This document is a grant application form requesting profile information and details of a proposed project from an organization. It requests information such as the organization's name, address, objectives, finances, current and past activities. It also requests a description of the proposed project, including objectives, duration, location, costs, beneficiaries, and expected impact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Berjaya Beneficiary-Application-Form-2024

    Uploaded by

    anisisnin
    28 views4 pages
    This document is a grant application form requesting profile information and details of a proposed project from an organization. It requests information such as the organization's name, address, objectives, finances, current and past activities. It also requests a description of the proposed project, including objectives, duration, location, costs, beneficiaries, and expected impact.

    Original Title

    Berjaya beneficiary-application-form-2024

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a grant application form requesting profile information and details of a proposed project from an organization. It requests information such as the organization's name, address, objectives, finances, current and past activities. It also requests a description of the proposed project, including objectives, duration, location, costs, beneficiaries, and expected impact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    28 views4 pages

    Berjaya Beneficiary-Application-Form-2024

    Uploaded by

    anisisnin
    This document is a grant application form requesting profile information and details of a proposed project from an organization. It requests information such as the organization's name, address, objectives, finances, current and past activities. It also requests a description of the proposed project, including objectives, duration, location, costs, beneficiaries, and expected impact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 4

    GRANT APPLICATION FORM

    SECTION A: PROFILE OF BENEFICIARY

    Please provide all information requested in the fields below and sign the accompanying
    statement.

    1. Name of Organisation:

    2. Date of establishment: Type of organisation:

    3. Address:

    Tel: Fax: Email:

    Website:

    4. Founder’s Name and Details:

    5. Patron (if any):

    6. Contact person:

    Tel: Mobile: Email:

    7. Organisation’s objectives:

    8. Tax Status: Yes Tax-exempt ref. no.

    No

    9. Organisation’s Demographics:

    a) Number of full time staff: b) Number of part time staff:

    c) Number of volunteers:

    d) Number of residents/ dependents @ 2024:

    Age group:

    < 6 years 6-12 years 13-18 years

    19-30 years 31-50 years ____________ > 50 years _____________

    Page 1 of 4
    10. Total monthly operating expenditure:

    11. Source of income:

    12. Grant from Government: Yes

    Type of grant :

    Amount: RM per year

    No

    13. Rented or own premise:

    14. On-going programmes/ activities:

    15. Have you ever received funding from Berjaya Cares Foundation or other companies related to
    Berjaya Corporation group of companies? If yes, please quantify and elaborate.

    16. Other supporting documents required:

    Most recent annual report / audited accounts

    Memorandum of Articles of Association

    Registration certificate showing non-profit status

    Letter from Inland Revenue Board showing tax-exempt status (*for tax-exempt organization)

    Page 2 of 4
    SECTION B: PROJECT PROPOSAL

    1. Project name:

    2. Project objectives (Expected result):

    3. Project description (Background/ Summary of the project):

    4. Project duration (Please append project timeline.):

    5. Project location (must be located within Malaysia):

    6. Total Project cost :

    7. Project cost breakdown:

    8. Other source of funding for project, if any (Please include contributors’ name and amount):

    Page 3 of 4
    9. Beneficiaries of the project (E.g. children, youth, single mothers, etc.):

    10. Measurable impact that could be expected :

    11. Sustainability and risk assessment (estimated challenges or limitation for the project not to
    achieve its objectives):

    12. Additional information relevant to this proposal.

    Statement:
    I certify that the information provided in this application form are true, correct and complete.

    Signature

    Name :

    Designation :

    Date :

    Please send the completed form to:


    Berjaya Cares Foundation
    c/o Berjaya Corporation Berhad
    Group Corporate Communications
    Level 12 West Wing, Berjaya Times Square
    No. 1 Jalan Imbi, 55100 Kuala Lumpur
    Tel: 03-2149 1999 Fax: 03-2144 0935

    *Successful applicants will be required to submit progress and completion reports as appropriate,
    supported by receipts and other relevant documentation. Projects will be subject to monitoring during
    the course of implementation.

    Page 4 of 4

    You might also like