251658240
THE RED UMBRELLA FUND - GENERAL APPLICATION FORM 
1. CONTACT INFORMATION	
A. GROUP INFORMATION:	

Full name of your group:		
Full postal address (where mail can be received):
Street, City, Postcode:
Country:	

Phone number:		
Fax number:		
E-mail address:		
Website, Facebook and/ or Twitter account (if available):		
When was you group created?:		
Does your group have legal registration?		
Does your group have an own  bank account where international transfers can be received?	
	
B. CONTACT PERSON:	
Full name:		
Position within the group:		
Email address:		
Skype name (if available):		
C. REFERENCES: Please give the names of  2 people or groups that we may contact for reference:	

2. MISSION:	
a. Main mission of your group:		
b. Main issues your group is working on:
(for instance human rights, health, sexual and reproductive rights, violence, social justice)		
c. Strategies to achieve your mission:		
d. Partners, networks, groups you work with:		

3. GOVERNANCE AND STRUCTURE OF YOUR GROUP:	
a. Is your group led by sex workers?		
b. Who are the main decision makers in your group?		
c. Please describe how the people you serve are represented in the leadership of your group?		
d. Number of paid staff (if applicable):		
e.Number of volunteers (if applicable):		
f. Number of members (if applicable):		
g.Number of board members (if applicable): 		
h. How does your group make strategic decisions about its direction and future?		
i. How does your group make day-to-day decisions?		

4. CONTEXT:	
a. Situation Please provide a short description of the situation that your group wants to change in the long term:	
	
b. Focus group Please provide a detailed description of the focus group or groups  you work with (for instance a specific population or sub-group of sex workers; gender identity, age categories, health issues, etc.): 	
	
c. Successes Please give examples of 2 successes or achievements of your group so far:	

5. FINANCIAL SITUATION OF YOUR GROUP 	
Please indicate the time span of your group’s fiscal year
 (month to month)		
			
A. CURRENT FISCAL YEAR 	Amount in
 local currency	Amount in
EURO	
Total (planned) expenditures in current fiscal year		€	
Total (expected) income in current fiscal year		€	
Sources of income (membership fees, donations, grants, etc) 
Please provide below the names of the donors you receive funding from.	
	Secured/Expected			

			€
€
€
€
€	
TOTAL INCOME		€	

B. PREVIOUS FISCAL YEAR  	Amount in 
local currency	Amount in 
EURO	
Total expenditures in previous fiscal		€	
Total income in previous fiscal year		€	
Sources of income (membership fees, donations, grants, etc) 
Please provide below the names of the donors you received funding from.	

		€
€
€
€
€	
TOTAL AMOUNT 		€	
6. GRANT REQUEST INFORMATION:	
a. Please indicate the amount of your grant request:.	In local currency	In Euro	
			
b. For what period do you request funding? (The period in which the activities funded by the RUF grant are planned to take place)	Start date:	End date:	

c. What do you want to achieve with this grant, and how will that contribute to change the current situation:	
	
d. Please specify how you plan to spend the requested funds, in the budget sheet below (double-click on sheet).	

7. COMMENTS: Please provide any extra information that you wish to share with us:	

Please send the fully completed application form before 15 September 2012 by post or email to:	

The Red Umbrella Fund
c/o Mama Cash
P.O. Box 15686
1001 ND Amsterdam
The Netherlands

www.redumbrellafund.org             info@redumbrellafund.org

(if you send the application by post, make sure it is delivered on time to be included in the review)