National Science Week 2008
(10 – 17 May 2008)
Application and Submission of Proposal Form
 For SAASTA office use only
Project:	SAASTA Ref Number:	Closing Date:

Please complete all fields of this form, stating N/A (not applicable) where appropriate. 
1.	Organisation’s Background Information
Name of Organisation/Institution	
	
Type of Organisation/Institution	
	
Organisation’s Reference/Registration Number
		
Province where the Organisation/Institution is located		
Physical Address for courier purposes (Please include person if different from Project Leader)

Mailing Address of Organisation/Institution
		
Organisation’s Telephone Number (both land line and cellphone)		
Organisation/Institution’s Fax Number		
Organisation’s/Institution’s e-mail address		

2.	Project Proposal Details
Project Overview: Briefly summarize your project in a way able to give the reader a quick grasp of it. Include in this description among others: 
•	target audience
•	nature of activities
•	mode of implementation
•	reach/coverage and 
•	how your project will address the thrusts and objectives of the project. (Maximum 1 Page)	

	

3. Your Project Duration

PROJECT DURATION (in days) 	STARTING DATE
	PROJECT LOCATION (Province & Name of Place(s)/Site(s)	

4. Your Project outreach
			
OUTREACH PROJECT LOCATION AND DATE	STARTING DATE
	PROJECT LOCATION (Province & Name of Place(s)/Site(s)	

5. Integration with Existing Projects

Name  and brief description of the Existing Project	Target Audience (band/location)	Own contribution 	

			

6.	Project Implementation Strategy - Project Thrust and Objectives
Thrust	Objectives 	Delivery Approach(es)/Activities
Give brief description of each activity and list your activities with the necessary information as per the example below. You may have as many activities per thrust and objective as you wish. 	Topic	Target Audience
Please indicate grades as well, e.g. learners (grade 7), educators (grade 5-7), parents (grade 12 or general), students 2nd year etc	Intended number to be reached please indicate number per target group	
1.  Scientific Areas where provinces have knowledge and geographical advantage

	1 Create awareness of the important role science play’s in people’s daily lives	ACTIVITY 1 (Give brief description of activity)
Content:
Duration:
Frequency per day and/week:
Inhouse or outreach: 
Format:
ACTIVITY 2 (Give brief description of activity)
Content:
Duration:
Frequency per day and/week:
Inhouse or outreach: 
Format:
				
	2 Encourage our youth to consider studying & improving their performance in maths and science	ACTIVITY 1 (Give brief description of activity)
Content:
Duration:
Frequency per day and/week:
Inhouse or outreach: 
Format:
				
	3 Attract more of our youth into SET careers	ACTIVITY 1 (Give brief description of activity)
Content:
Duration:
Frequency per day and/week:
Inhouse or outreach: 
Format:
				
2. Indigenous Knowledge

	1 Create awareness of the important role science play’s in people’s daily lives	ACTIVITY 1 (Give brief description of activity)
Content:
Duration:
Frequency per day and/week:
Inhouse or outreach: 
Format:
				
	2 Encourage our youth to consider studying & improving their performance in maths and science	ACTIVITY 1 (Give brief description of activity)
Content:
Duration:
Frequency per day and/week:
Inhouse or outreach: 
Format:
				
	3 Attract more of our youth into SET careers	ACTIVITY 1 (Give brief description of activity)
Content:
Duration:
Frequency per day and/week:
Inhouse or outreach: 
Format:

7. Publicity
(Indicate how you intend to market the project locally)

	

8.	Project Implementation Plan (how you plan to roll-out the project)

Activity/Milestone	Progress Indicator	Means of verification	Target Date	

9.	Project implementation plan for Focus Week (10 May – 17 May 2008)	

Province:
		
Date	Venue	Description of activities	Target Audience	Enquiries	Bookings 
Required?	

						

10.	Project Team

Designation	Responsibility	Initials and Surname	Contact number	E-mail address/fax number	

					

11.	Details of Project Leader

Title and Surname 		
Full Names 		
Nationality		
Identity Number		
Present Position in the Organisation/Institution		
Similar Projects Undertaken previously		
Telephone Number (Landline and cellphone)		
Fax number		
E-mail Address		
Physical Address		
Summary of Academic Qualifications		
Summary of Relevant Experience		
Brief Career History		
Recent Publications		

12.	General Project Administration Information

Authorised Signatory for Organisation/Institution 	Name	Position	

Name and designation of Project Financial Administrator

	Name	Position	

Alternative Contact Person if Project Leader is Unable to Complete Obligations
	NAME	Position	

13.	Organisation/Institution Banking Details

Name of account holder
		
Type of account
		
Name of Bank
		
Branch
		
Bank Branch Code
		
Bank Account Number

14.	Project Budget 

Detailed budgets that include VAT must be submitted in the range as stipulated in your call  depending on the capacity of the organization and intended reach of project  Please provide full details of all expected costs of the project (list separately under the main headings) as outlined in the table below and refer to footnote regarding capital equipment. 

Item	Cost (Rand)	
Professional costs (facilitators/staff costs)		
Travel & Subsistence		
Consumables		
Event costs		
Production & printing		
Distribution		
Administrative and support costs		
Others….		
		
Total Cost		
Other funding sources (source & purpose)		
Amount requested from SAASTA		

15. Organization/Institution Business Profile

No of Employees	
	
Organisation Management
(E.G. CEO, Director, HOD, partners etc)

	NAME	POSITION	
			
Nature of Core Business

		
Indicate Financial Controls in Place

	
Date of Last Audited Annual Financial Statement		
Name and Address of Auditors

		

16.	Referees

Please provide the names and contact details of two reputable persons who can attest to the quality of your work. 

Name	Organization & designation	Telephone	Email	

				

17. Submission of Proposals

Applications must be submitted on a properly completed submission form.
Closing date: Friday 14 September 2007. 

By email to:	johnc@saasta.ac.za
By fax to:	(012) 320 7803
By post to:	John Chauke, Project Officer
		SAASTA
		PO Box 1758
		PRETORIA
0001
By hand to:	John Chauke, Project Officer
		Didacta Building
		211 Skinner Street
		Pretoria
		0002