Global Grant Proposal Form for Project G-1272

Section A: Host and International Sponsor Information

1. Host Partner Information

The host partner is a: Club

Last Name:

First Name:

Email:

adcores95@gmail.com

Phone:

District:

3292

Club:

Kathmandu Metro

2. International Partner Information

The international partner is a: Club

Last Name:

Thakur

First Name:

Ajay

Email:

dr.ajaythakur@gmail.com

Phone:

6202535270

District:

7090

Club:

Buffalo Niagara Medical Campus

Section B: Community Needs

1. Describe the benefiting community including its location, using any relevant geographic and demographic information (Please be as specific as possible). If the activity is a scholarship, enter "N/A".

Lapa is a village community in the Northern district of Dhading in Nepal. It is Northwest of Kathmandu located in very mountainous terrain. There is no clean drinking water.

2. What community needs have been identified? If the activity is a scholarship, enter "N/A".

The community needs clean drinking water.

3. How are these needs currently being addressed with local resources and/or government agencies, NGOs, etc.? If the activity is a scholarship, enter "N/A".

At this time the Lapa community is working with Himalayan HealthCare and the Rotary Club of

to establish a sustainable clean drinking water project.

Section C: Activity Description

1. Summarize the proposed activity(ies) in 250 words or less, including the need it will address, the intended beneficiary(ies), and the potential benefits to the community.

The need for clean water is well established. HHC has conducted health assessments and documented epidemic gastroenteritis. The community is well organized and educated via school programs and adult education classes regarding the need and benefits of a clean drinking water source.

The community has a clean water committee and is willing to charge families for clean water in order to sustain the clean water infrastructure. There is a clean water spring above the village. Water from the spring will be collected and held in a cistern. It will be purified and piped to distribution points.

2. Please list any cooperating organization(s) or university(ies) involved in the proposed activity(ies).

Himalayan HealthCare

Lapa citizens committee

Dhading municipal

3. Describe how the benefiting community will be involved in the activity(ies) (Provide specific examples). If the activity is a scholarship, enter "N/A".

Citizens committee will employ workers to maintain the source and distribution. As above citizens will pay a small fee for clean water.

4. Has the benefiting community(ies) confirmed that it would like the activity(ies) to take place?

Yes. See letter of intent.

5. Proposed Start Date: --

6. Proposed Completion Date: --

Section D: Area of Focus

1. With which area(s) of focus is the proposed activity aligned?

[  ]

Peacebuilding and conflict prevention

[  ]

Disease prevention and treatment

[X]

Water, sanitation and hygiene

[  ]

Maternal and child health

[  ]

Basic education and literacy

[  ]

Community economic development

2. Please describe how the activity(ies) will address the goal(s) of the area(s) or focus.

Clean water will improve the health of the community.

Section E: Project Outcomes

1. What will be the immediate and long-term outcomes of the activity(ies).

Decreased rates of illness and death.

2. Explain how all involved parties will act to ensure the sustainability of the activity(ies) and/or outcomes.

HHC will monitor via

Committee will

Rotary Club will

Section F: Budget

Category

Budget Item

Supplier/Vendor

Local
Amount

USD
Amount

Total Budget

-

$0

Section G: Financing

DDF Amount in US$

$13,000

Rotarian Cash Amount in US$

$149,334

Additional Outside Funding in US$

$0

Requested TRF Match in US$

$87,667

Total Financing in US$

$250,001