Urgent Action Fund Africa

ORGANISATIONAL INFORMATION

Organization Name

Office Line

Country

Address

Email

Organisation’s mission or main focus of work and when it was formed.

Contact Person Name

Contact Person Title

Endorsing Organisations

Funders that can endorse your work

Email Address

Phone

Funders that can endorse your work

Email Address

Phone

Funders that can endorse your work

Email Address

Phone

Amount Of Request

Full Amount in Words

Detailed Budget

Please state your area of activism. How long have you been active in this area?

Provide a detailed description of the event that has led to your request. When did this event occur?

Have you received support for this similar situation in the past?

What measures have you already taken to protect yourself?

Outline your immediate steps for protection once the funds have been received.

Do you have plans after the 3-month period of this grant?

What other support have you received and from whom?