Regional AIDS Training Network P.O Box 16035-00100, Nairobi, Kenya Tel: +254-20-2635929, 2635938, Mobile: +254 73499975, 724255849 Email: ratn@ratn.org, Website: www.ratn.org
Appendix to the Expression of Interest APPLICATION FORM A.1 Applicant identification INFORMATION REQUIRED CONTACT DETAILS Address:
REGISTRATION DETAILS
Telephone: Fax: E-mail: Website: Date of registration: Country of registration: Registration number:
A.2 Contact person INFORMATION REQUIRED TITLE Mr/Ms/Dr/other NAME Surname: First name: DESIGNATION CONTACT Email: DETAILS Tel:
B. Applicant Profile What is the mission statement of the applicant organisation?
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Regional AIDS Training Network P.O Box 16035-00100, Nairobi, Kenya Tel: +254-20-2635929, 2635938, Mobile: +254 73499975, 724255849 Email: ratn@ratn.org, Website: www.ratn.org
B1. (a)
Type of your organisation (please tick/shade) appropriately: Community-based organisations (CBO) working on HIV and AIDS
(b) National Network of AIDS Service Organisations (c)
National Civil Society Organisation working on HIV and AIDS
(d) Other Specify B2.
Please list any organisations /bodies that your organisation is a member of or is affiliated to;
B3.
Provide the following details on size of your organisation in terms of number of permanent staff and budget in the last three (3) years
Year 2012 2011 2010 B4.
No. of full time staff
Annual Budget (US$)
Please provide an overview of the project (s) or programmes your organisation has implemented in the past three years: Name of project Keys Project Year(s) of Donor(s) Outcome(s) implementation
1. 2. 3. C. Applicant’s Information for RBM intervention C1.
Describe how your organisation applies or understands Results Based Management principles?
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Regional AIDS Training Network P.O Box 16035-00100, Nairobi, Kenya Tel: +254-20-2635929, 2635938, Mobile: +254 73499975, 724255849 Email: ratn@ratn.org, Website: www.ratn.org
C3.
Please answer the following question by ticking the appropriate box
i. No.
Question
ii.
To what extent is your organisation using results information to manage and adjust on-going operations, strategic plans, policies and resources To what extent is there tangible support from management for building and supporting resultsbased management? To what extent is RBM-based training available to managers and staff throughout the organisation? To what extent do the appraisal systems in your organisation relate individual accomplishments to outcomes? To what extent do your organisation’s values and ethics reflect an outcome focus? To what extent is risk management systematically practiced in your organisation and linked to outcomes To what extent does your business plan/strategic plan specify organisation-wide performance expectations that are clear, concrete and timebound? To what extent are outcome measurements linked to financial measures To what extent is evaluation integrated into the management of programs and policies To what extent are results data used for internal managing?
iii.
iv.
v.
vi. vii.
viii.
ix. x. xi.
Advanced
Beginning
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Not Started
Don’t know
Regional AIDS Training Network P.O Box 16035-00100, Nairobi, Kenya Tel: +254-20-2635929, 2635938, Mobile: +254 73499975, 724255849 Email: ratn@ratn.org, Website: www.ratn.org
C4
Overall, how would you rate your organisation in terms of practice of Results Based Management?
1. Advanced
2. Not started
3. Beginning
4. Do not know/ Not sure
C5.
Briefly describe why your organisation is applying for capacity building for Results Based Management (RBM) (If space is not enough use separate page but maximum one (1) page)
C6. Does your organisation have the following documents? Please tick as appropriate Type of Document Yes No 1. 2. 3. 4. 5. 6. 7. 8. 9.
Constitution for the Organisation Registration certificate Audited Accounts for last Financial Year Annual Report for last Financial Year Organisational chart Current Strategic Plan Annual work-plan Monitoring and Evaluation Plan/Framework Organisational Capacity Statement/Profile
C7. If yes to C6 (6) above, is the current Strategic Plan fully funded? (tick one) Yes fully funded
Yes Partially funded
Not funded
………………………………………END…………………………………………
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Not Applicable
Regional AIDS Training Network P.O Box 16035-00100, Nairobi, Kenya Tel: +254-20-2635929, 2635938, Mobile: +254 73499975, 724255849 Email: ratn@ratn.org, Website: www.ratn.org
ANNEX 2 to the Call for Expression of Interest RECABASO/11/12 RECABASO: Eligibility Criteria IMPORTANT: RECABASO Team reserves its right to verify the accuracy of the information provided by the Applicant by means of due diligence, if required. ELIGIBILITY CRITERIA
System of appraisal (for RECABASO use only) Yes / No
1.1
The Applicant is an AIDS service organisation
1.2
The Applicant is based in the Eastern and Southern African region
1.5
The Applicant has declared interest in RBM capacity building
1.6
The Expression of Interest is prepared in accordance with Annex 1 to the Call for Expression of Interest. All necessary supporting documents are provided.
1.7
The Expression of Interest and the relevant appendices/annexes are duly signed.
1.9
The Expression of Interest is submitted both by registered mail and email.
1.10
The Expression of Interest is submitted within the Deadline.
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Regional AIDS Training Network P.O Box 16035-00100, Nairobi, Kenya Tel: +254-20-2635929, 2635938, Mobile: +254 73499975, 724255849 Email: ratn@ratn.org, Website: www.ratn.org
ANNEX 3 to the Call for Expression of Interest RECABASO/11/2012 RECABASO: Award Criteria No.
AWARD CRITERIA
Evaluation (weighting) For RECABASO use only
1.1
Eligibility criteria met as per Annex 1
30
1.2
The applicant’s organisational governance structure
20
1.5
Applicant’s demonstrated need and interest in Results Based Management
20
1.6
Applicant’s potential to demonstrate results
10
1.7
Assessment of relevant supportive document
20
Total
100
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