Sample application form - Interreg IVC

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Table of ContentsCover PageINCOMPLETEGeneral Instructions for filling in the Application FormChecklist for submissionSection 1: Project SummarySection 2: Detailed Description of the Project2.1 Rationale2.2 Policy contextINCOMPLETEINCOMPLETEINCOMPLETEINCOMPLETEINCOMPLETE2.3 Management and coordinationINCOMPLETESection 3: ComponentsINCOMPLETE3.0 Component ‘Preparation activities’3.1 Component 1INCOMPLETE3.2 Component 23.3 Component 33.4 Component 43.5 Component 5Section 4: Budget4.1 Budget overview by budget lines and components (in EUR)INCOMPLETEINCOMPLETEINCOMPLETEINCOMPLETEVALID FOR FIRST CALL ONLY4.2 Payment forecastINCOMPLETE4.3 Specification of budget line ‘External expertise and services’4.4 Specification of budget line ‘Equipment’Section 5: PartnershipINCOMPLETE-2-
General Instructions for filling in the Application FormThis Application Form is part of the “application pack” for INTERREG IVC applicants. Before filling in this Form, pleasalso read all programme related documents, especially:a) the INTERREG IVC Operational Programme andb) the Programme Manual .In particular, the Programme Manual will provide you with further guidance on the way to develop an INTERREG IVCproject and to prepare the application form. The two above mentionned documents are available on the programmeweb site (www.interreg4c.net).Paper versionApplication FormThe Application Form must be completed, printed out, dated, signed by a duly authorised representative of the LeadPartner, and stamped with the stamp of the Lead Partner’s institution. It should be sent together with the annexes (cofinancing statements and project time plan) by mail/courier to the INTERREG IVC Joint Technical Secretariat (JTS) atthe latest by the end date of the call. This will be checked through the date of postal stamp on the envelope. The JTSaddress can be found on the programme's web site: www.interreg4c.netCo-finaning statementsCo-financing Statements in original or fax version must be included in the mail sent to the JTS for all partners listed inSection 5 of the Application Form. The standard form of the co-financing statement available on the Programmewebsite must be used, no amendments to the text are allowed. The figures listed in the co-financing statements mustcorrespond to the individual budget figures of each partner given in Section 5 of the Application Form.Project Time planA project Time plan must also be included in the mail to the JTS. A template is available on the programme web site beach project is free to propose its own time plan.Electronic versionAn electronic version of the completed Application Form must be sent by email to the JTS at the latest by the end dateof the call at the following address application@interreg4c.netTechnical instructions• Applicants are asked to complete only the white fields of this Application Form. For technical reasons, most of thewhite fields have been split up into 2 or 3 sub-fields. As soon as the first sub-field is filled in, please continue in thenext sub-field.• Grey fields are not to be completed. For the grey fields, certain information will automaticaly be transferred to thesesections after details are entered in other fields of the Application Form. Formulae for automatic calculations have beeincluded in the relevant fields. These fields cannot be changed or edited.• All input fields (white fields) are locked in order to ensure that all applicants have the same amount of space fordescribing their project and answering the questions. The number of characters (with spaces) is limited to 1000characters per field. Any text exceeding this space will not be visible in the printout and therefore cannot be taken intoaccount when assessing the operations.• All input fields must be filled in unless stated otherwise in the instructions field. As different Sections ofthe Application form depend on the type of interventions, it is strongly recommended that theapplicants start by selecting the type of intervention they are applying to.• Certain questions in the Application Form must be answered by marking a tick-box. When clicking on thebox, an arrow will appear. Please click on the arrow and select the option provided in the drop-down field,which will appear on the screen.• If you want to use a bullet point list in any of the input fields, please press ‘Alt+Enter’.Application Forms with error messages or with uncompleted Sections will automaticallybe declared ineligible.VALID FOR FIRST CALL ONLY-3-
Page 1: AcronymTitle of the projectType of
Page 5 and 6: Section 1: Project Summary1.1 Acron
Page 8 and 9: P5ERDF Funding: EU Nat. Cofi Other:
Page 10 and 11: P35ERDF Funding: EU Nat. Cofi Other
Page 12 and 13: Section 2: Detailed Description of
Page 14 and 15: 2.1.3 Objectives of the projectPlea
Page 16 and 17: Field depends on Type of interventi
Page 18 and 19: 2.1.7 Components of the projectActi
Page 20 and 21: 2.2 Policy context2.2.1 Contributio
Page 22 and 23: 2.2.3 Consistency of the project wi
Page 24 and 25: 2.3 Management and coordination2.3.
Page 26 and 27: 2.3.3 Strategic levelPlease describ
Page 28 and 29: Section 3: Components3.0 Component
Page 30 and 31: ActivitiesJul-Dec 2009Output(s)Acti
Page 33 and 34: ActivitiesJan-Jun 2014Output(s)Acti
Page 35 and 36: 3.2.2 Component general description
Page 41 and 42: 3.3 Component 33.3.1 Component main
Page 43 and 44: 3.3.3 Detailed work plan(if no acti
Page 49 and 50: These fields depend on type of inte
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ActivitiesJul-Dec 2012Output(s)Acti
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3.5 Component 5As the fields below
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3.5.3 Detailed work plan(if no acti
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ActivitiesJan-Jun 2011Output(s)Acti
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ActivitiesJan-Jun 2014Output(s)Acti
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4.3 Specification of budget line
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Description of external expertise /
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Description of ‘Equipment’Contr
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Please describe the relevance of th
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Contact details of partner 8Institu
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Sample application form - Interreg IVC

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