Small Grants Application Form

My application

0 - Eligible countries

* Required fields

Country of project implementation *

Has your organization already been supported by the Mérieux Foundation grant program? If so, you will need to specify in your application the link between the submitted project and the project that received support. *

Yes

1 - My organisation

* Required fields

Name and acronym of organization *

Legal status *

Year of creation *

Address *

Post Code

City *

Country *

Phone

Website *

Mission of the organization *

2 - Legal representative of the organization

First name *

Last name *

Position *

Email *

Phone

Is the legal representative of the organization also the point of contact for this grant application? *

Yes

3 - Contact person

The project

4 - General Information

5 - Context and justification of the project

6 - Project objectives

7 - Project beneficiaries

8 - Activities

9 - Expected changes and indicators

10 - Sustainability of the project

11 - Operational partners

12 - Budget and financial partners

13 - Files to attach

Copy of the organization’s official articles of association*

Copy of the registration declaration with the competent authorities of the country of intervention*

Activity report for the structure’s two previous years*

Budget and accounts for the previous financial year of the structure (certified by the competent authorities)* Certified by the competent authorities

Detailed budget of the project according to the following model: File link from the Mérieux Foundation.*

Any references to the organization's financial and operational partners

Any useful document relating to the project

14 - Finalization

By submitting this form, I confirm that I am authorized to represent the applicant organization *

By submitting this form, I declare that I understand and accept without reservation the collection and processing of my personal data in accordance with the Privacy Policy of the Mérieux Foundation. *