Expression of Interest At Development Exchange Centre (DEC)

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UMARNI: CIKA WANNAN TAKARDA A HARSHEN TURANCI, SAI A SA HANNU, SAÁNAN A MIKA TA IMEL. A MADADIN HAKA,

CIKA WANNAN TAKARDA A HARSHEN TURANCI, SAI A BUGA, A SA HANNU A TAKARDAR, SA’ANAN A MIKA.

A YI NAZARI DA URMARNIN MIKA WANAN TARKARDA.

1. GENERAL INFORMATION- BAYANI NA JANAR

Name of CBO/Group Sunan CBO/Ƙungiya			Answer (Amsa):
Acronym of CBO/Group Takaitaccar sunan kungiya Gajartan sunan kungiya			Answer (Amsa):
Physical Address Adireshin kungiya			Answer (Amsa):
Year Established Shekara kafa kungiya		Answer (Amsa):		Area of Focus Jigon jaddadawa	Answer (Amsa):
Details of contact person- Cikakkun bayani na tuntubar kungiya
Name Suna	Answer (Amsa):
Email Imel	Answer (Amsa):
Website Adireshin gidan yanar gizo na kungiya	Answer (Amsa):
Position Matsayi	Answer (Amsa):			Telephone Lambar tarho		Answer (Amsa):

2. ORGANIZATIONAL BACKGROUND- BAYANIN KUNGIYAR

2.1 Is CBO/Group registered?  Yes ☐  No ☐ . If yes, please attach a copy of registration certificate.

An yi rijistar CBO/Ƙungiya?eh ☐ aá ☐. Idan an yi rijista, a haɗa kwafin takardar shaidar rajista.

2.2 Do you have a constitution or by-laws?  Yes ☐ No ☐ .If yes, please attach a copy.  

Kuna da kundin tsarin mulki ko dokoki?eh ☐ aá ☐. Idan eh, a haɗa kwafi takardan.

2.3	How many persons make up your organisation? Mutane nawa ne a kungiyar ku ?	Female Mace	Answer (Amsa):	Male Namiji	Answer (Amsa):
2.4	How many are paid staff/volunteers? Mutane nawane maáikata/masu aikin sa kai ?	Female Mace	Answer (Amsa):	Male Namiji	Answer (Amsa):

• Provide the information of key staff/volunteer/member in your organisation/group using the table below: Cika bayanan manyan ma’aikatan / masu aikin sa kai / memba a cikin ƙungiyar ku.

Sn	Name Suna	Position Matsayi	Staff/Volunteer Maáikata/ masu aikin sa kai	Sex jinsi	Age Shekaru	Date Appointed Ranar daukan aiki
1
2
3
4
5

2.6 Describe how your staff/member is recruited/selected. Bayyana yadda ake ɗaukar ma’aikatanku/memba/zaɓe a kungiyar.
Answer (Amsa):
2.7 How do you maintain, manage, and sustain your staff/members? Ta yaya kuke sarrafa, da kuma kula da ma’aikatan ku / membobin ku?
Answer (Amsa):
2.8 Do you have a management team/officials/leader? Kuna da ƙungiyar gudanarwa / jami’ai / shugabanni?					Yes ☐   No  ☐  Eh   Aá
If yes, how many of your staff/members belong to the management/leadership team? Idan akwai, nawa ne daga cikin ma’aikatanku/mambobi ke cikin ƙungiyar gudanarwa/shugabanci?				Female Mace		Answer (Amsa):	Male Namiji	Answer (Amsa):
2.9 What is the main responsibilities of the management/leadership? Menene ayyukan masu gudanarwa/shugabanni?
Answer (Amsa):
2.10 How often do they meet? Sau nawa suke haduwa?
Answer (Amsa):
2.11 Which of the staff/member have experience in project and financial management and for how long? Wanene daga cikin ma’aikatan / membobin ke da gogewa a cikin aiki da sarrafa kuɗi kuma har tsawon wane lokaci?
Sn	Name   Suna		Area of competence Yankin kwarewa			Years of experience Shekarun kwarewa a cikin wannan damar
i
ii
iii
2.12 Do you have a Board? Kuna da Hukumar shawara?			Yes ☐  No ☐    Eh    Aá
If yes, how often does the Board meet? Idan da, sau nawa ne hukumar shawara ke haduwa?
Answer (Amsa):
2.13 What is the responsibility/role of the Board? Menene ayyukan hukumar shawara?
2.14 How is the decision-making process in your organization/group? Yaya tsarin yanke shawara yake a cikin ƙungiyar ku?
Answer (Amsa):
2.15 Do you have policies on: Kuna da dokoki akan
Finance Sashen kudi		Yes ☐  No ☐    Eh    Aá
Administration Gudanarwa		Yes ☐  No ☐    Eh    Aá
Others: Dokoki sauran batutuwa:
Answer (Amsa):

3. FINANCIAL MANAGEMENT- GUDANAR DA HARKOKIN KUDI

3.0 Does your organization have a bank account? Kungiyar ku tana da asusun banki?							Yes ☐  No ☐    Eh    Aá
If No, go to item 3.7 and skip items 3.1 to 3.6. If Yes, go to item 3.1 to 3.6, then skip item 3.7 Idan A’a, je lambar tambaya 3.7. Idan eh, amsa tambaya lambar 3.1 zuwa lambar 3.6, sannan ka tsallake tambayar lamba 3.7.
3.1 Name of bank Sunan banki
3.2 Address of bank Adireshin banki
3.3 Account number Lambar akant
3.4 Status of bank account Matsayin asusun banki			Active ☐               Inactive ☐    Asusun ta na aiki. Asusun ta na barci.
3.5 Type of account Nau’in asusun		Personal savings/ current ☐ Asusun ajiyar kuɗi na mutum     Corporate account ☐ Asusun kamfani						Is account linked to ATM card?   An haɗa asusun da katin ATM?	Yes ☐ No ☐ Eh    Aá
3.6 Name & position of signatories to your bank accounts. Suna da matsayi na masu sanya hannu a asusun bankin ku.
Name; Suna				Position; Matsayi
3.7 How is your bank mandate implemented? Yaya ake aiwatar da umarnin bankin ku?
3.7 How do you handle funds when you do not have a bank account? Ta yaya kuke sarrafa kudade tunda ba ku da asusun banki?
Answer (Amsa):
3.8 What is your average annual budget? Menene matsakaicin kasafin ku na shekara?					Answer (Amsa):
3.9 Funding for the last 3 years: Enter name of source and amount; Kudade na shekaru 3 da suka gabata: Shigar da sunan tushen kuɗi da adadin kuɗi
Year Shekara	Name of source; Sunan tushe					Amount in Naira. If in foreign currency, enter the equivalent as at the period. Adadin Naira. Idan a cikin kuɗin waje, shigar da daidai kamar yadda yake a lokacin.

• MAIN AREAS OF WORK- BABBAN BANGAREN AIKI

4.1 List the main programme areas of your organization/group.Jera manyan wuraren shirye-shiryen ƙungiyarku.
a.
b.
c.
d.
4.2 State the aims/objectives of your organization.Faɗa makasudin ƙungiyar ku
a.
b.
c.
d.
e.

• CHALLENGES- KALUBALE

Please list in order of priority the main challenges confronting your organization. 

Lissafa cikin fifikon manyan ƙalubalen da ke fuskantar ƙungiyar ku:

a.
b.
c.
d.

• PROJECT DETAIL- Bayanin shirin aikin

Descriptive name of project: Siffanta sunan aikin:	(e.g.: Supporting social inclusion of women in XX community through …….) Misali: Taimakawa haɗa kai da mata a cikin al’ummar XX ta hanyar…….)
	Answer (Amsa):
Title of project Taken aikin	Answer (Amsa):
Theme/sector Jigo/bangare	Answer (Amsa):
Location of proposed projectWurin da aka tsara aikin	State, LGA, District, Community Jiha, LGA, gunduma, sunan gari/unguwa
	Answer (Amsa):
What level of approval is required for implementing the planned activities? How will it be acquired? Wane matakin amincewa ake buƙata don aiwatar da ayyukan da aka tsara? Ta yaya ake samun wannan amincewa?
Answer (Amsa):
Expected start date and duration. Watan farawa da tsawon lokacin da ake tsammanin.	Answer (Amsa):
Context/Background: (not more than 300 words)- Mahallin halin da ake ciki (zama musamman ga al’amurran da suka shafi wurin da aka tsara aikin/Shirin:(kada ku wuce kalmomi 300)
Answer (Amsa):
Rationale/ Reason for support (not more than 300 words)Dalilin tallafi (kada ku wuce kalmomi 300)
Answer (Amsa):
Purpose/objectives of the project.Makasudin/manufofin aikin.
Answer (Amsa):
Project strategy and activities. Dabarun aiki da kuma ayyuka
Answer (Amsa):
Describe the target beneficiaries and the expected results on them (describe expected outcomes and beneficiaries): (not more than 300 words) Ƙayyade masu cin gajiyar manufa da sakamakon da ake sa ran a gare su (kada ku wuce kalmomi 300)
Answer (Amsa):
Budget estimate: Ƙimar kasafin kuɗi
Answer (Amsa):

• SIGNATURE OF PERSON(S) COMPLETING THE TEMPLATE –MUTUM/MUTANE DA KE CIKA FOM A MADADIN ƘUNGIYA

Name Suna		Position Matsayi
Signature Sa hannu		Date Kwanan wata
Name Suna		Position Matsayi
Signature Sa hannu		Date Kwanan wata