2 Concept Note Form

8/13/2019 2 Concept Note Form

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European Commission

European Initiative for Democracy and

Human Rights

CONCEPT NOTE FORM



NOTICE

"ll personal data 'such as names) addresses) *+s) etc.( mentioned in your conceptnote form ,ill -e processed in accordance ,ith Regulation 'E*( &o 4#$001 of the

European /arliament and of the *ouncil of 1 Decem-er $000 on the protection of

individuals ,ith regard to the processing of personal data -y the *ommunity

institutions and -odies and on the free movement of such data. our replies to the

2uestions in this form are necessary in order to assess your grant application and they

,ill -e processed solely for that purpose -y the department responsi-le for the

*ommunity grant programme concerned. 3n re2uest) you may -e sent personal data

and correct or complete them. or any 2uestion relating to these data) please contactthe *ommission department to ,hich the form must -e returned. Beneficiaries may

lodge a complaint against the processing of their personal data ,ith the European Data

/rotection 5upervisor at any time '3fficial 6ournal 7 ) 1$.1.$001(.1

/lease read and complete this form ,ith all due care) in accordance ,ith the guidelines

for applicants.

/lease note that the procedure has changed. ou ,ill only -e re2uested to su-mit a

full application form if your concept note is pre8 selected. our full application ,ill

then undergo evaluation. he eligi-ility conformity chec: ,ill only -e performed for

the full applications that are provisionally selected according to the score o-tained

after the technical evaluation) on the -asis of the supporting documents re2uested -y

the European *ommission and the Declaration -y the applicant signed and sent

together ,ith the concept note) and the second version sent together ,ith the

application form



IICONCEPT NOTE FORMAT

he *oncept &ote must ans,er 4 sets of 2uestions in a ma>imum of 4 pages 'those must -e

ans,ered on ma>imum 1 page 8 the font si?e cannot -e smaller than "rial 10(. "ny *oncept &ote not meeting those -asic re2uirements ,ill -e re@ected ,ithout appraisal.

Please provide the following information:

4 #ummar* of the action

1.1 Brief description of the proposed action.

2 Rele+ance:2.1 How relevant is your proposal to the needs and constraints of the target country(ies)

or region

2.2 !hat are the pro"lems to "e resolved and the needs to "e met

2.# !ho are the actors involved (final "eneficiaries$ target groups)

2.% !hat are the o"&ectives and e'pected results

2. !hat is the added value of the action (what adds the action "y reference to (central or

local) government action and actions implemented "y non state actors)

, Metho%olog* an% #ustaina'ilit*:

#.1 !hat are the main pro&ect activities

#.2 !ho will "e your main implementing partners$ if any$ what is the length of your

relationship with them and how will they "e involved in the pro&ect

#.# How will the pro&ect achieve sustaina"ility

#.% !ill it have multiplier effects



I. DECLARATION BY THE APPLICANT

A. T*" +%$-+') &"-%+/" )*+):

• It has the sources of financing and professional competence and qualifications specified in section 2.3 of the Guidelines for Applicants.

• It undertakes to comply with the principles of good partnership practice foreseen in section III.2 of the grant application form.• It is directly responsible for the preparation and management of the action with its partners, and is not acting as an intermediary.• It and its partners do not fall in any of the categories (a to (f list in section 2.!.!(2 of the Guidelines for Applicants.• If selected, it is in a position to deli"er in the second phase, immediately upon request, the supporting documents stipulated under point 2.# of the

Guidelines for Applicants

F/)*"//", )*" +%$-+') &"-%+/" )*+) : T !" #$%%"& $' !()*" +%$-+')

T !" #$%%"& $' !()*" E/"+'C$$'

1. I) $ "%$$!%" $' +--/&+'-" $)* )*" -/$)"/$+ ") ) '&"/ $') 2.1.1 # )*" $&"%$'".5

2. P+/)'"/ 1 $ "%$$!%" 6$' +--/&+'-" $)* )*" -/$)"/$+ ") ) '&"/ $') 2.1.2 # )*" $&"%$'".5 6$# +'(5

5

3. P+/)'"/ 2 $ "%$$!%" 6$' +--/&+'-" $)* )*" -/$)"/$+ ") ) '&"/ $') 2.1.2 # )*" $&"%$'".5 6$# +'(57

4. P+/)'"/ 7 $ "%$$!%" 6$' +--/&+'-" $)* )*" -/$)"/$+ ") ) '&"/ $') 2.1.2 # )*" $&"%$'".5 6$# +'(58

NB: add as many rows as partners

B. SIGNATURE:

I, the undersigned and person responsible in the applicant organisation for the concept note, certify that the information gi"en in this $eclaration is correct.

$ate%

&ame% 'ignature%

osition%

4 /lease indicate A&ot "pplica-le '&"( if you have no partner

/lease indicate A&ot "pplica-le '&"( if you have no partner

% /lease indicate A&ot "pplica-le '&"( if you have no partner

%



= A##E##MENT GRI"

>FOR T$E 3#E OF T$E E3ROPEAN COMMI##ION ON!?@

?E# NO

1. he Deadline has -een respected

$. he *oncept &ote form satisfies all the criteria mentioned in the *hec:list '5ection III of the *oncept &ote form(.

he verification of the *hec:list has -een conducted -y CCCCCCCCCCCCCCC 3n the CCCCCCCCCCCCCCCCC..

"ECI#ION 4: The Committee has %eci%e% to recommen% the Concept Note for Technical E+aluation after ha+ing passe%

the A%ministrati+e chec.

'If not) reasons must -e encoded in the "dministrative chec: rid in *RI5) in the "dministrative *hec: report in *RI5) and in

the letters sent out to applicants(.

"ECI#ION 2: After ha+ing pre(selecte% the 'est Concept Notes the Committee has appro+e% the present Concept Note

an% reueste% the pre(selecte% applicant to su'mit a full proposal

'If not) reasons must -e encoded in the *oncept &ote Evaluation rid in *RI5 this includes the evaluation sheet for assessors

and delegations) in the *oncept &ote Evaluation report and in the letters sent out to applicants.(

F

2 Concept Note Form

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