Expression of Interest - Beneficiary

Expression of interest in I4J Initiatives for beneficiary

A - Contact Person's Details

Please provide the following contact information:

First Name
Last Name
Title
Home Address
Address (cont.)
City
State
Zip/Postal Code
Mobile Phone
Home Phone
FAX
E-mail
Website
Position in Organization

B. Organization Details

Please provide the following information about your organization:

Name of Organization
Office Address
Address (cont.)
City
State
Phone
FAX
E-mail
Website
Nature of Business
Type of Organization

C. Project Details

Please provide the following project information:

Title of Project
Project  Objective
Type of Project
Short Description of  Project (You will be required to send detail proposal later)
Detail Proposal, if available now
How many people is the
project likely to employ?

 Directly

Indirectly
Which area would you apply the I4J Grant? (Please Select) Web Application Development
 Training (IT)
 Training (Entrepreneurship)
 Marketing 
Target market for services to be provided (Please Select) Global
 National
 State (s)
Please list
Local Government
Please List  
Target Age group for the services to be provided  All Ages
16 years below
17 - 30 years
31 - 50 years
51 - 70 years 
70 and above