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FU TAK IAM FOUNDATION LIMITED
PRELIMINARY APPLICATION FORM


Name of project:



Amount requested:
(HKD or please specify)



Organization name:
(as appeared in effective legal document)



Website:



Tel:


E-mail:


Address:


Established in:
HK
China
Macau
Others
(please specify: )

Chief executive

Name:


Post title:



Is your organization registered with the government as a not-for-profit or charitable organization?
No
Yes

Registration No.:


Country of registration:


Is auditor's report available for review?
Yes, most recent year:
No


Current year annual budget of organization
(HKD or please specify)



Project-in-charge regarding this project

Name:


Post title:


Profession:


Office tel:


Office e-mail:


Office fax:
(optional)


Mobile:
(optional)


Immediate supervisor

Name:


Post title:



Period of funding support applied:

From to (e.g. Jan-2016)

(Please only choose one)
Less than one year
One to less than two years
Two years
Over two years (please specify )
Type of the project:
(Please select only one)
New Project
Extension to on-going project
Scope of the project:
(Please select only one)
Social welfare
Education
Medical & health
Amateur sports
Animal welfare
Arts & culture
Environment & conservation
Heritage


Beneficiaries of the Project:
(Please choose the major one)
Animals
Children & youth
Disabled persons
Disaster victims
Elders
Ethnic minorities
Families
General population
Patient group
Specially for men
Specially for woman
Service practitioners (e.g. lawyers, doctors, teachers, volunteers, etc)
Others (please specify: )


Service area of the Project:
Hong Kong
China
Macau
Others (please specify: )





I. Briefly summarize the Organization's :
(1) the background,
(2) mission, and
(3) services or work.

II. If the proposed project concerns a particular department only, specify and briefly describe the services or work of this department.

III. Analyze the needs or problems that justify the proposed Project.

IV. Concisely describe the proposed Project, state the
(1) objectives,
(2) target group, no. of beneficiaries,
(3) contents, and
(4) timelines.
(within 400 words)

V. Required attachments (Max file upload size for each file is 30MB)

(Note : If any of these required attachments is absent and no acceptable resaon is provided herewith, this preliminary application will not be entertained, and no notification will be sent to the applicant.)

    1. Most recent annual report of your Organization

    

    or Link:

    2. Most recent full auditors'report

    

    or Link:


Explanation in the absence of both the “link” and “upload”




#

Confirm that the above information is correct