National Youth Council is the Advocate, Connector and Enabler for Youth. Prided as Singapore's premium graduate club, NUSS is a common meeting Together with our partners, NYC develops a vibrant and supportive environment ground for fellow graduates to engage with each other and enjoy the finer for youth who are inspired to dream and committed to action to bring about a future things in life. NUSS offers abundant opportunities for members to share and that they want. delve in the strong and lasting intellectual heritage amassed over the years. NYC is part of the People's Association Network. GRANT APPLICATION FORM Instructions: 1. 2. Complete the application form. All sections are compulsory unless otherwise stated. Submit the grant application form with all necessary supporting documents to the National University of Singapore Society at least 8 weeks before the programme/project commencement date for all grant schemes. Applicants are advised to read the grant guidelines and FAQ prior to the grant application. 3. Successful applicants can receive up to $3,000/- or 80% of project cost, whichever is lower, to cover project costs. (1) APPLICANT (Refers to Staff-In-Charge, Project Team Leader, Youth Applicant, Principal Investigator / Researcher, etc.) Name as in NRIC/Passport Mr (underline surname) Ms Mrs Mdm Dr NRIC/Passport No.* (Please delete accordingly.) Nationality (Please tick accordingly. Only Singaporeans and Singapore PRs can apply for all grants. Foreigners can only apply for SAYF.) Singaporean Singapore PR (Resident of _________________ {country}) Date of Birth (ddmmyyyy) Race Occupation Age Gender: Male/Female * Section/Dept/Faculty/Organisation Address Contact Details (Office/Home) (Mobile) (Fax) (Email) Page 1 of 3 (2) INTER-BANK GIRO DETAILS FOR PAYMENT (a) Please provide bank details of Youth Applicant/Team Leader/Team Member/Team Leader’s (b) The grant will be credited into the bank account, if the application is approved. Bank Name Branch Name Account Number Name of Account Holder (3) DECLARATION AND ACCEPTANCE 1. I hereby certify that the information given is to the best of my knowledge and I agree to abide by all the terms and conditions on NUSSNYC grants. I understand that the application will be decided at the sole discretion of NUSS/NYC. I also understand that NUSS/NYC has the right to reject my application should the information I submit be incomplete and/or inaccurate. NUSS/NYC shall reserve the right to review, reduce, suspend, terminate or withdraw the assistance in accordance with the stated terms and conditions. NUSS/NYC reserves the right to act on the breach of its terms and conditions at any point in time. Any decision undertaken by NUSS/NYC is final. 2. I have also ensured the following in my submission (Please '√'): □ I have completed all relevant sections of the application form, including the relevant Annex and the budget template. □ I have attached all other necessary documents [e.g. Appendix-Project Team Details and other supporting documents] required for my application to be processed. 3. I understand that upon receipt of my satisfactorily completed application, NUSS will notify me the outcome of the project application. Funds disbursement for a successful application will be made to my account as provided within 8 weeks from date of notification. 4. I understand that NUSS/NYC reserves the right to share information pertaining to my grant application with relevant stakeholders at its sole discretion. Name and Signature of Applicant Date Revised as of 02 May 2013 Page 2 of 3 (4) PROGRAMME/PROJECT Name of Programme/Project Date(s)/Duration of Programme/Project Venue of Programme/Project (Please indicate State/Province/Country if programme is conducted overseas.) Grant Amount Requested for Programme/Project: S$ _____________________________ Outreach Numbers (if applicable) No. of Youth Leaders (Organising Team): No. of Spectators: (Youth Leaders are people who organise or spearhead proposed event) (Please provide particulars of each team member, including team leader/applicant, using the Project Team Details template at the Appendix.) (Spectators are people who attend the event e.g. crowd during an exhibition or concert performance audience) No. of Volunteers (excluding core organising team): (Volunteers are people who help out on event day) No. of Participants: (Participants are people who take part in the event e.g. performers, workshop trainees, competition entrants etc) No. of Beneficiaries: (Beneficiaries are people you help in a community service project e.g. the people you fund-raise or volunteer for, or deliver a service to) Please tick the most relevant category for your project. Programme/Project Category Arts, Culture & Heritage Community Service Technology & Knowledge Transfer Education Environment Health Leadership Mentoring Research Social Enterprise & Income Generation Sports & Adventure Special Needs Youth Development Others: __________________________ (5) PROJECT PROPOSAL Please complete the respective Annex C - Project Proposal template and submit together with your application. Please submit the completed application with all necessary supporting documents to the National University of Singapore Society EMAIL: [email protected] FAX: (65) 6778 8095 or MAIL: Membership Services The National University of Singapore Society Kent Ridge Guild House 9 Kent Ridge Drive Singapore 119241 Revised as of 02 May 2013 Page 3 of 3 Annex C YOUNG CHANGEMAKERS (YCM) GRANT PROPOSAL TEMPLATE Note: Please include the team members’ details in Appendix. 1. Provide a detailed description of the project. 2. Provide details of the project’s objectives and measurable outcomes. 3i. Describe how this project meets the needs of your target community. Please also provide details of the beneficiaries of your project. 3ii. [For OS-YCM Applicants only]: Describe how the project will promote interactions amongst Overseas Singaporeans (e.g. in the form of networking, exchange of ideas, experience, etc. 4. For repeated projects (i.e. projects that have received YCM funding previously), , please explain how this latest project is significantly different/ better than the previous project . 5. Provide details of project partners, if any. APPENDIX Details of Project Team Members Instructions for Use 1. Please follow the specified format - an example has been provided to illustrate the required format. 2. Please include the particulars of all project team members, including the leader(s) in this form. 3. Do not leave any cell empty unless otherwise stated. S/N As appears in passport Family name Given name e.g. Tan e.g. Beng Seng For Singaporeans & PRs only: NRIC No. (Leave the field blank if not applicable) e.g. S1234567A For non-Singaporeans and non-PRs only: Date of Birth Foreigner No. DD MM YYYY (Leave the field blank if not applicable) e.g. XYZ-12345-7 e.g.12 12 1980 Age Gender (M/F) e.g. 30 e.g. M Page 1 of 2 Mailing Address Email Address Handphone No. e.g. Blk 1 Toa Payoh Lor 1 #11-1234 S(310001) e.g. [email protected] e.g. 91234567 Nationality Ethnic Group e.g. Singaporean e.g. Chinese Religion Organisation & Employee or Institution & Student (Type Nil/NA if not applicable) e.g. BJC student Page 2 of 2
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