Steven Davids, Skeppies Fund, Application Form, South Africa

1. 1
Small Grants Facility for Conservation and Development in the Succulent
Karoo
A partnership project between CEPF, DBSA, CI, and SKEP
c/o Kirstenbosch Botanical Garden
Private Bag X7
Claremont, 7735
SOUTH AFRICA
Tel: +27-21-799-8852
Fax: +27-21-762-6838
Cell: 073-843-2702
Website: www.skep.org
Email: s.davids@conservation.org
Application Form and its Guidelines
• It is always best to first contact the SKEPPIES project team and discuss your idea
with them. They can tell you if your project fit our criteria and funding portfolio’s and
can guide you to give your application a better change of success.
• Please complete all the questions to the best of your ability as this will speed up your
application.
• If you do experience any problems in filling out this application form, do not hesitate to
contact us at the above address because we regard our applicants as future partners
and are here to help you.
• You may use a pen to fill in the form, but the completed application form must be
submitted in electronic format as this will help distributing it among our panel of
reviewers. Should you not have computer facilities or email, please contact us so that
we may assist you in this regard.
• When submitting this form, please ensure that letters of support from all project
partners are included.
• Send or email the completed application to our supplied address.
• Please bear in mind that the funding application procedure takes time. We generally
try to provide feedback within 14 days of submission. However, we are the process
of moving over to a quarterly project selection process.
• The application form may also be completed in Afrikaans.
• All applications must be accompanied by a visual application using digital photos.
Examples of these are provided.
• All successful applicants must at least attend one anchor project exchange forum
meeting to inform other’s of their project. This cost must be budgeted for or else the
applicant must carry this out of his own pocket.

2. 2
ANSWERS IN THE FORM OF TEXT or TICKS.
QUESTIONS Use only this column for your answers.
PART 1: GENERAL
1. Project Title
2. Total amount you applying for. This amount
must not exceed R 140,000 per application per
annum.
3. Give a one paragraph description of your
project. Use only the space provided:
4. Date of application
5. Duration Do not write in this block
5.a. Enter the estimated date the project will start
5.b. Enter the estimated date the project will end.
6. Please give the GPS coordinates of the location
of your project. Many new cell phones have this
function. If you do not have it or know what this Do not write in this block
is, your SKEPPIES project developer will assist
you with this.
6.a. South
6.b. East
7. In what SKEP area is your project located (please Do not write in this block
tick)?
7.a. Western Cape
7.b. Northern Cape
7.c. Both Western & Northern Cape
8. In what SKEP area is your project located (please Do not write in this block
tick)?
8.a. Bushmanland
8.b. Klein Karroo
8.c. Hantam-Tanqua-Roggeveld
8.d. Knersvlakte
8.e. Namaqualand Coastal
8.f. Namaqualand Uplands
8.g. Greater Richtersveld
8.h. Central Breede River Valley
8.i. Biome Wide (or more than 2 hotspots)
9. Has your project proposal been examined by the
relevant SKEP Priority Area Projects Forum.
Only answer YES or NO. If not, the proposal may
be reviewed by local experts and revisions may

3. 3
ANSWERS IN THE FORM OF TEXT or TICKS.
QUESTIONS Use only this column for your answers.
be requested
9.a. If Yes, at give a date of the meeting and a copy
of the decision.
10. Which ONE of the following SKEPPIES funding
directions for conservation does your project Do not write in this block
link to? PLEASE TICK THE ONE ASPECT that
describes your project best.
10.a. Biodiversity-based businesses
10.b. Environmental “Best Practices” in agriculture
10.c. Environmental “Best Practices” in mining
10.d. Establish a protected area
10.e. Restore degraded land in key biodiversity area
10.f. Tourism activities
10.g. Biodiversity education within the context of the
project
11. The National Strategy for Sustainable
Development identifies various priority areas for
strategic intervention. The document is available
on the website http://www.environment.gov.za
Motivate which ONE of the following SKEPPIES Do not write in this block
funding directions for development your project
will contribute to. Use only the space provided.
PLEASE USE ONLY THE ONE ASPECT that
describes your project best.
11.a. Use natural resources efficiently and sustain
ecosystems. Examples of these projects are
improving water, air, soil quality; waste
management; climate change; food security,
and ecotourism.
11.b. Creating sustainable green communities.
Examples of these projects are green buildings;
green procurement; energy and watersaving;
and the recycle of solid and liquid waste.
11.c. Enhancing systems for integrated green
planning. Examples are projects that redefine
development projects (the IDP's and SDF's) to
be ecosystem and resource enhancing rather
than environmentally destructive.
11.d. Building capacity for sustainable development.
Examples of these projects are building the
capacity local government; skills development;
community empowerment; direct engagement
with communities
Do not write in this block
12. State the measurable DEVELOPMENT impact of

4. 4
ANSWERS IN THE FORM OF TEXT or TICKS.
QUESTIONS Use only this column for your answers.
your project:
12.a. Number of new businesses or ventures started.
12.b. Number of existing businesses that will get
added value from the project.
12.c. Number of people involved in capacity building.
12.d. Number of people that will be reached through
awareness raising.
12.e. Number of new jobs created.
12.f. Number of women empowered through project.
12.g. Number of youth that is people younger than
35 years.
PART 2: State the measurable CONSERVATION impact of
your project. You may not know this. Please contact your
SKEPPIES project developer or someone from SANBI who
will assist you with this.
1. Climate change adaptation / mitigation Do not write in this block
1.a. Is this project located within the Namaqualand
Wilderness Initiative biodiversity corridor (yes /
no)
2. Support SKEP ecological processes Do not write in this block
2.a. Does project support a river corridor (yes/no)
2.b. Does project support a sand movement
corridor (yes/no)
2.c. Does project support a quartz and gravel
Succulent Karoo corridor (yes/no)
3. Contribution towards BIODIVERSITY TARGETS Do not write in this block
3.a. SKEP Vegetation targets Hectares
better
Hectares managed,
Vegetation type
added restored,
sustainably
used
3.b. SKEP Plants or any Red Listed plants
3.c. SKEP Reptiles or any Red Listed (Reptiele
soos akkedisse, slange, skilpaaie)
3.d. SKEP Birds or any Red Listed birds (voels)

5. 5
ANSWERS IN THE FORM OF TEXT or TICKS.
QUESTIONS Use only this column for your answers.
3.e. SKEP Amphibians or any Red listed (paddas)
3.f. SKEP Invertebrates or any Red listed (98%
van alle diere is invertebrate. Dit is diere
sonder inwendige been soos wurms, insekte,
slakke)
3.g. SKEP mammals or any Red listed (soog diere
soos molle en rotte)
3.h. SKEP Fish or any Red listed
PART 3: ELIGIBILITY QUESTIONS
1. Do you plan to use any of the potential project
funds to purchase land? Answer YES or NO.
2. Does your project involve the removal or
alteration of any physical cultural property
(includes sites having archeological,
paleolontogical, historical, religious, and unique
natural values)? Answer YES or NO.
3. Does your project involve the relocation of
people or any other form of involuntary
resettlement? Answer YES or NO.
4. Do you plan to use any of the potential project
funds to capitalize a trust fund(s)? Answer YES
or NO.
5. Are you an international NGO? Answer YES or
NO.
PART 4: ORGANISATION'S INFORMATION
1. Tick off one of the descriptions below that best
describes your type of organisation. All of these Do not write in this block
organisations qualify for a SKEPPIES loan.
1.a. Government
1.b. Parastatal
1.c. Non-governmental organisation (NGO)
1.d. Community-Based Organisation or group
(CBO)
1.e. Training, education and research institution
1.f. Individual with a good cause
1.g. Private sector (including Small and Medium
Enterprises)
1.h. Networks (e.g. Environmental Education
Networks)
1.i. Traditional authority

6. 6
ANSWERS IN THE FORM OF TEXT or TICKS.
QUESTIONS Use only this column for your answers.
1.j. Faith based organisation
2. Name of Applying organisation
2.a. Physical address (Street name, number etc)
2.b. Town
2.c. Postal address (P.O. Box number etc)
2.d. Town of Post Office box
2.e. Postal Code
2.f. Telephone number
2.g. Fax number
3. Years that your organization has been in
Operation
4. Total number of permanent staff
5. Provide a brief description of your organisation’s
Mission and History. Use only the space
provided.
6. Motivate in the space provided why you are the
best institution/individual to undertake the
proposed project.
7. Name of Main Contact Person
7.a. Cell number of main contact
7.b. Email address of main contact
8. Name of Alternate Contact Person
8.a. Cell number of alternate contact
8.b. Email address of alternate contact
PART 5: FINANCIAL ACCOUNT INFORMATION
Name of account holder
At which bank do you have an account e.g. ABSA, FNB.
Name of the Branch
Branch Code
What type of bank account do you have e.g. cheque, savings
What is your bank account number?
Does the organization have a valid tax clearance certificate?
If not, please get one because if the application is approved, it
is a requirement that you should have one in order for the
money to be paid over to you.

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PART 6: Give a 2-5 page description of your proposed project including the following
1. Background: Why you want to do the project? In other words what problems and issues do you want to
address or what opportunities does your project want to take advantage of?
2. What do you want to do? In other words how does your project plan to address the issues and
opportunities; or solve the problems that were identified in the previous question?
3. Clearly state what the CONSERVATION impacts are your project will achieve. Remember, your project
must have both a development and conservation aspect.
4. Clearly state what the DEVELOPMENT impacts are your project will achieve. Remember, your project
must have both a development and conservation aspect.
5. Where do you plan to do it? In other words in what villages, towns, municipal areas, etc?
6. What potential problems do you think you 7. How do you plan to overcome these problems?
might encounter in your project?
8. Who will benefit from your project?
9. Why do you think the project will be sustainable and continue to exist when the SKEPPIES funding period
ends?
10. What is the exist strategy of the project developer or champion to ensure that the project does not
become dependent on him but that it will indeed be self sustainable?
11. Does your project link with other projects, and in particular with other SKEP projects? What value does it
get from or add to those projects?

8. 8
PART 7: HOW DO YOU PLAN TO DO PROJECT AND WHAT YOU PLAN TO DO
How do you plan to do the project? In other words name the major phases of your project and
describe what you intend doing in each phase. How long you think it will take to reach each
phase. Please set this information out in table form as illustrated below.
Measurable out
Phases Main Activities Timeframes
comes
PART 8: PROJECT BUDGET AND PARTNER INFORMATION
1. Why do you apply specifically to SKEPPIES for funding for this project?
2. Did you apply to other organizations for financial funding for this project?
2.a. If you did not apply, what are the reasons.
2.b. If you did apply, what are the names of the organizations, for what amount did you apply and what
was the response of the organization?
Amount you
Name of the organization the response of the organization
applied for
3. Give an outline of how you plan to spend the project money.
ITEM COST
Visit to local Anchor project exchange forum to inform them of project
SUBTOTAL:- COST OF PROJECT CARRIED BY APPLICANT

9. 9
4. List the source/s and amount/s of any other funds or in kind donation already obtained,
or for which you have applied for this project.
NB: Please attach letter/s from partner organisations stating HOW they support this project.
COST
(if organization gives in
kind donation, where
Summary of how it Contact Details
Organisation possible, give a
supports the project. (E-mail / Tel / Fax,) reasonable estimate of
the value of the in kind
donation)
SUB TOTAL: COSTS OF PROJECT CARRIED BY PARTNERS
PART 9: OFFICIAL USE – NOT TO BE FILLED IN BY APPLICANT
Risk Category
PART 9: OFFICIAL USE – NOT TO BE FILLED IN BY APPLICANT
(Questions and inputs from panel and applicant’s responses to them. To form part of contract)
__________________ ___________________
Signature of applicant Date