Application - ORTEC Foundation

Step 1

Your project

Legal organization name *

Project title *

Short project summary *

Project duration (Start date) *

Project duration (end date) *

Where will the project be executed and implemented? *

Step 2

Societal problem & approach

What is the core societal problem that you are addressing? *

What are the main interventions that you would be supporting, i.e. how will our contribution be used? *

Are other organizations already addressing this problem? *

YesNo

How does your approach differ from theirs?

On what do you base your confidence that your approach will be (more) successful? *

Step 3

ORTEC Foundation fit & collaboration

How are mathematics, optimization, analytics and/or technology involved? *

Do you have other partners collaborating with you in this project? *

YesNo

Who and how? *

Have you explored and agreed upon such involvement prior to this application? *

YesNo

Please specify the details of the agreed support, including scope of work, FTE allocation, hours, and any associated costs. *

Please specify the details of the agreed support. *

Step 4

Expected impact

Who are the beneficiaries of your project, direct and indirect? *

How many direct and indirect beneficiaries do you expect? *

How will impact be measured? What is your monitoring and evaluation approach? *

What lasting change will remain after completion of the project? *

If successful, can this project be replicated or scaled to other regions, sectors or beneficiary groups? How? *

Step 5

Funding

What is the total project budget? *

Please explain

What amount are you requesting from ORTEC Foundation? *

Please explain

What is your organization's own contribution? *

Please explain

What other funding has been secured so far? *

Please explain

Step 6

Team, governance & sustainability

Who are the key team members responsible for delivery of the project? *

What relevant expertise and track record do they bring? *

Do you or any key persons involved in the project have a relationship with the ORTEC Foundation, its Board or Advisory Board, or ORTEC?

YesNo

Please briefly explain *

What are the main risks of the project and how do you intend to mitigate them? *

How do you ensure the sustainability of (the results of) this project? *

Could the project generate commercial or other positive financial results? If so, how will these be used for sustainable or societal impact? *

Step 7

About your organization

Short description of your organization

Country of registration *

Official registration number *

Does your organization have ANBI status or a similar tax-exempt/public-benefit status? *

YesNo

Please specify *

Explain why *

Website *

Official address *

Step 8

Contact, documents

Name *

Function *

E-mail *

Telephone number *

Required uploads

Most recent registration excerpt from the relevant official register *

Most recent annual report *

If applicable, signed written confirmation of agreed involvement of external partners, including ORTEC

If applicable, detailed project plan and - budget

Any other documents you deem relevant.

Step 9

Final Question

If the ORTEC Foundation funds only one project this year, why should it be yours?

Review

I hereby confirm that I am authorized to submit the application form on behalf of the organization; that the information provided is complete and accurate to the best of my knowledge; and that I am aware that submission of an application does not create any entitlement to funding.

Application Form

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Step 7

Step 8

Required uploads

Step 9

Review