International Fund for Cultural Diversity (IFCD)

Application Form for Programmes/Projects for Parties and NGOs

NB: International NGOs must fill out a separate form

The IFCD provides support for programmes/projects undertaken by applicants from developing countries that are Parties to the Convention. Proposals may be aimed at facilitating the introduction of cultural policies, strengthening institutional infrastructure 1 , providing capacity building opportunities, fostering new cultural industries, protecting cultural expressions at risk. APPLICATION PROCEDURE: Parties and national NGOs submit Applications both in original signed form and in digital form (in .rtf, or .doc format) to their countrys National Commission for UNESCO or an alternative official channel designated by the State Party. The National Commissions will review the applications and submit up to four shortlisted ones (two from Parties and two from NGOs) to the UNESCO Secretariat. APPLICATION DEADLINES: Applicants are to consult their National Commissions for UNESCO to find out about the deadline for receipt of applications at the national level. The deadline for the UNESCO Secretariat to receive funding applications from National Commissions is 30 June 2012, midnight CET. Applications received after this deadline will not be eligible for evaluation.

Form n
(to be completed by UNESCO)

1. Name of applicant: This entity will be responsible for implementing the project, including its financial management. Ministerio de Cultura y Juventud de Costa Rica (MCJ). 2. Type of applicant: The beneficiaries of the IFCD are developing and least-developed countries that are State Parties to the Convention. This applies to all types of applicants. See the Explanatory Note for a complete list of eligible applicants. Please check only one of the below:

For the purpose of the IFCD, institutional infrastructure should not be interpreted as physical construction or restoration but rather as management, human resources, etc.

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

XX

State Party NGO

Please check below if the following applies to your entity/organization: Represents vulnerable groups and other social groups (Article 7 of the 2005 Convention)

3. About the Applicant Please note that the applicant will need to have a bank account registered in the name of the organization if the project is approved. 3.1. Main mission and activities of applicant:
In the case of an NGO application, please provide its date of establishment, main activities, website and any other relevant information to show its direct relevance to the objectives of the Convention. (Max. 400 words)

Mission The Ministerio de Cultura y Juventud is the governing body of national policies in these areas, and it is in charge of promoting and preserving the diversity and cultural diversity, as well as to facilitate the participation of all social sectors in the processes of cultural and artistic development, without regard to gender, ethnicity, and geographic location by opening up spaces and opportunities that foster revitalization of traditions and cultural events, the enjoyment of cultural goods and services and the creation and appreciation of art in its various manifestations.

Strategic Objectives of the Institution 1) To promote, preserve, and project all different cultural forms in every region and among all different human groups that coexist within and outside of our territory. Thus, we will be able to promote participatory model for development that will allow the communities to enjoy the goods and the social, cultural, and artistic services. 2) To promote the creation of spaces, opportunities and mechanisms that will promote civil participation. So, that all communities will be able to access and enjoy the goods and the social, cultural, and artistic services to improve their quality of life. 3) To encourage the cultural and artistic promotion, as well as their different manifestations at the country, regional, and community level to stimulate and support designers, artistic groups, cultural organizations, and the community overall. As a result, all of these would be encouraged to participate in the different management and cultural development processes, as well as to revitalize and to promote values, traditions and cultural and artistic manifestations that strengthen the national identity. 4) To recover, preserve, protect, and spread our historical and cultural heritages respect in different fields: architectural, documentary, bibliographical, archeological, and intangible heritage to strengthen our identity as a country.

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

5) To create spaces and opportunities that increase the youths participation without regard to gender to make them participate in the decision making and solution building processes in an organized and compromised way, so that they can share their initiatives, requests, and expectations. 6) To design and implement policies and actions addressed to develop the Sistema Nacional de Bibliotecas (National Library Organization) turning them into entities of information and communication able to promote and encourage reading by using new technologies available, especially those peoples who have been historically excluded.

3.2. Name and position of key staff members directly employed by the applicant and working
on the programme/project: Please list all key persons working on the proposed programme/project, their position in your organization and their main activities/areas of responsibility. Anah Moyano Larrea, Advisor to the Ministers Office on International Relations and Coordinator of the Comisin de Cultura y Economa. Carmen Luisa Madrigal Girn, Advisor to the Ministers Office on Institutional Affairs, responsible for the project "Caribbean Cultural Corridor," and Coordinator of the Unidad Tcnica-MCJ for the Proyecto Limn Ciudad Puerto. Alejandro Tosatti Franza, Vice-Minister Adviser's Office, experiencedproject developer focused on the design of cultural identity. Ana Lorena Herrera Loaiza, Head of Departamento de Cooperacin Internacional of the Ministerio de Cultura y Juventud

4. Title of the program / project:

Strengthening the Capacity of the Costa Rican Caribbean Cultural Industry on Music, Gastronomy, and Craft/Design. ___________________________________________

5. Length of programme/project: This is a nine-month-and-a-half project, and it will be running

resources from March of 2013, as indicated. Please note that programmes/projects must begin in March 2013 at the earliest. UNESCO cannot issue contracts for approved programmes/projects prior to this date.

Beginning date: 03/01/13

End date: 12/15/13

6. Brief summary of the programme/project:

Please provide a brief summary description of the programme/project. A more detailed description of activities and expected results is requested in sections 11 and 14 below. (150 to 250 words)

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

The project has been designed to develop the skills of the cultural industry through a process of training farmers and tradition holders from the Caribbean in three fields: music, craft/design, and gastronomy. It attempts to improve life quality for the people of this area which is known by the resourcefulness of their cultural diversity. This improvement should acknowledge, make visible, and empower their identity by cherishing their products, which are their cultural expression. The purpose is to develop and strengthen the skills of the beneficiaries through a process of three components: The first component aims to develop human cultural capital by improving their specific production techniques to their process. This component will target 60 beneficiaries. The second component aims to develop the product design, emphasizing on identity. The third component will address the same beneficiaries of the previous component, and, at the same time, it will aim to develop entrepreneurial skills of farmers (12 farmers in each group is estimated). For the organization of the project, it has been established to hire a support staff consisting of one producer and two people responsible for formulating and ensuring that the conceptual framework of the proposal is met.

7. Fields of activity of the IFCD addressed in the programme/project:

Please indicate which fields of activity of the IFCD are covered by the project (see paragraph 6.1 of the Guidelines on the use of resources of the Fund adopted by the Conference of Parties in June 2009). Check more than one box if necessary. introducing cultural policies and/or strengthening the institutional infrastructure; XX strengthening existing cultural industries or creating new ones.

8. Country context and justification of the programme/project

8.1. Please identify and explain the specific needs, priorities and challenges (economic, political and social aspects) faced by your community/city/region/country (depending on the scope of your project) in the field of culture, and indicate how your project is designed to respond to them in a targeted and direct manner. (Max. 400 words) Context: Limn province is the Caribbean area of our country. Limn is a sociocultural place characterized by its natural richness, a vast patrimony, and an afro Caribbean, indigenous, Chinese among its most distinctive cultural heritage.

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

Puerto Limn, the capital of the province, is the most important port of the country, but the surrounding communities face severe problems, which are reflected on the unemployment, poverty, and low social development indicators. All these trigger alcoholism, drug addiction, high school drop outs, in addition to the discrimination against this Caribbean region in a national context. Without taking into consideration its ports and all the economic activity they bring to the province, the fact that there is a different productive structure oriented towards traditional activities, considering the limited industrial development and the lack of productive sectors that limit the levels of investment, employment, and income that could benefit the region, reactivate the economy, or improve the life quality of the population. Justification: Having to face these issues, the existence of sociocultural capital is an important strength of the region, despite being underestimated, that has to be exploited on processes that lead to local development, which tends to strengthen the organizational base, the identity, and the entrepreneurial character of the farmers and tradition holders by strengthening the cultural industries of the region. The Calypso music, for example, is the less professional developed music expression in the country, in spite of being of great artistic quality. It is the less known and the worst paid. The Caribbean food is not fully integrated on the national gastronomy, but it is considered to be an exotic dish. The local craft/design is poorly projected, and despite its beautiful natural resources, it is hard to be set as a tourist destination mainly because of all the social prejudices against the population of the area.

Having this in mind, this project has as main objective to promote the development of cultural and social capital on the population to improve the quality of life of the community through the process previously explained.

8.2. Please provide information about other actors working in your field of activity and programmes/projects already started at the national and/or local level responding to the specific needs, priorities and challenges previously described. Indicate whether and how these actors and/or programmes/projects will be associated with your project, and what value your funding request adds to the work that is already being carried out in your field. (Max. 400 words)

In the Costa Rican Caribbean, efforts have been made by the Instituto Nacional de Aprendizaje (INA, translated as National Training Institute), the Instituto Nacional de la Mujer (INAMU, translated as the National Institute of Women), and the Ministerio de Economa, Industria y Comercio (MEIC, translated as The Ministry of Economy, Industry, and Commerce ) towards the formation of MSMEs, but these training efforts are not directed exclusively to the cultural sector, so that their essential purpose is the generation of MSMEs or jobs, and not as envisaged our project, the preservation and dissemination of Caribbean cultural heritage. In this regard, UNESCO-San Jos has identified the different cultural entrepreneurs of the Caribbean region. The MCJ has already worked withal of these entities in several ways; thus, there is fluid communication to avoid rework.

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

For this specific project, an ally with INA to develop the components regarding design and business strengthening is being considered. In this way, the level of expertise will increase which will generate more support for the main purpose of the project. The MCJ is currently working with MEIC and the Municipality of Limn on Proyecto Limn Ciudad Puerto, and it is working with UNESCO and community organizations on Proyecto Corredor Cultural Caribe. These two projects are closely related to this project and they could benefit from each other. The Ministerio de Cultura y Juventud will be the entity developer and will work in several ways with the entities previously mentioned.

9. Objectives:
Please describe the specific objectives of the programme/project (and not of the applicant). These should be in accordance with the main objectives and priorities of the IFCD (see Explanatory Note). Please distinguish between your short term and longer term objectives. Please indicate how these objectives contribute to the promotion of gender equality and/or youth in the fields of activity of the IFCD. (Max. 400 words)

General Objective
To strengthen the capacities of the cultural industry in craft/design, music and gastronomy from the Costa Rican Caribbean through training farmers and tradition holders to promote their organization, as well as the design, production, and marketing of their products and cultural services, moving from acknowledging and empowering the socio cultural capital, which in turn, preserves and safeguards the cultural heritage of the region. To achieve this general objective three specific objectives have been proposed.

Specific Objectives
1. To teach three workshop courses that will allow the development of human cultural capital, focusing on the intangible value of their products. 2. To teach three workshop courses that will allow the Caribbean farmer the development of their products by improving the design of them. 3. To teach three workshop courses to develop skills and business skills in Caribbean farmers. 4. To establish the necessary organizational structure for project implementation.

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

10. Beneficiaries:
Please specify which group(s) will directly and indirectly benefit from the implementation of your project and how. (Max. 200 words)

Direct beneficiaries
Project will benefit 60 people directly, farmers in the region of the Costa Rican Caribbean. The training process includes in its first stage 3 workshop courses (one for each specialty: craft/design, gastronomy, or music) of 20 participants each, depending on the promotion of this process. Three new groups will be formed on the next training stage, and this will also be made with the third training stage (it is estimated that in the last two stages of training, there will be a total of 12 students involved per course, i.e. 36 direct beneficiaries).

Indirect beneficiaries
The project's ultimate goal is to create conditions so that farmers could be able to establish themselves as cultural enterprises. Thus, those who could be constituted as such will demand products such as raw materials, equipment, and furnishings creating a positive linkage to these providers and making them into indirect beneficiaries. On the other hand, it is important to notice that, in general, the Costa Rican society will be an indirect beneficiary of the project, and that it ensures the conservation of cultural heritage of Costa Rican Caribbean food, music, and craft. 11. Main activities of the programme/project:
Please describe the proposed activities, the location(s) where they will be held and number them in the order in which they will take place. Information about activities to be undertaken to raise awareness of the programme/project in your country should also be included. You may wish to group the activities (research, workshops, publications, consultations, promotion, etc.) into distinct categories such as, but not limited to: capacity-building; mapping/inventorying; promoting exchange, interaction and network-building; awareness-raising and visibility.

Please make sure that each activity corresponds to the objectives, as described in section 9, to the expected results, as described in section 14, and to the budget, as described in section 16. (400 to 800 words)

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OBJECTIVES

ACTIVITIES

LOCATION

1. To form a conceptual and productive team that ensures the implementation of the project in the proposed conceptual framework.

1.1 To validate the profile of staff to recruit and to prepare terms of reference. San Jos, Costa

Rica

1.2 To make the recruitment process.

1.3 To conduct the staffs induction.

2. To teach a workshop course that allows the development of human cultural capital, focusing on the intangible value of its products.

2.1 To validate the workshops syllabus.

Limn-San Jos

2.2 To prepare training materials for the workshop. 2.3 To flesh out the logistics to deliver the workshop course. 2.4 To hire the workshop-course teachers. 2.5 To acquire food services for participants of the training process. 2.6 To run the workshop course. 3. To teach a workshop course that allows the Caribbean farmer the development of their products by improving the design of it. 3.1 To validate workshop syllabus.

San Jos

Limn

Limn-San Jos Limn

Limn Limn-San Jos

3.2 To prepare training materials for the

San Jos

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

workshop. 3.3 To flesh out the logistics to deliver the workshop course. 3.4 To hire the workshop-course teachers. 3.5 To acquire food services for participants of the training process. 3.6 To run the workshop course. 4. To teach a workshop course to 4.1 To validate workshop syllabus. develop skills and business skills in the Caribbean farmers. 4.2 To prepare training materials for the workshop. 4.3 To flesh out the logistics to deliver the workshop course. 4.4 To hire the workshop-course teachers. 4.5 To acquire food services for participants of the training process. 4.6 To run the workshop course. 4.7 To evaluate the formation process of the three courses. Limn

Limn-San Jos Limn

Limn Limn-San Jos

San Jos

Limn

Limn-San Jos Limn

Limn Limn

12. Activities implementation schedule:

Please provide an implementation schedule for your activities in the table below, making sure to note the beginning and end dates of all activities. NB: As stated in section 5, programmes/projects cannot start earlier than March 2013.

Description of Activity

Beginning date

End date

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

1.1 To validate the profile of staff to recruit and to prepare terms of reference. 1.2 To make the recruitment process. 1.3 To conduct the staffs induction.

03/01/13

03/01/13

03/01/13

03/15/13

03/18/13 2.1 To validate the workshops syllabus. 2.2 To prepare training materials for the workshop. 2.3 To flesh out the logistics to deliver the workshop course. 2.4 To hire the workshop-course teachers. 2.5 To acquire food services for participants of the training process. 2.6 To inaugurate the Process of Formation 2.7 To run the workshop course. (3 hours / day, 2 times / week, total 96 hours) 3.1 To validate workshop syllabus. 3.2 To prepare training materials for the workshop. 3.3 To flesh out the logistics to deliver the workshop course. 3.4 To hire the workshop-course teachers. 3.5 To acquire food services for participants of the training process. 03/18/13

03/20/13 03/20/13

03/20/13

03/29/13

03/18/13

03/22/13

03/18/13

03/29/13

03/18/13

03/29/13

04/01/13

04/01/13

04/01/13

06/28/13

06/03/13 06/10/13

06/07/13 06/21/13

06/03/13

06/07/13

06/03/13

06/14/13

06/17/13

06/28/13

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3.6 To run the workshop course. (3 hours / day, 2 times / week, total DE72 hours) 4.1 To validate workshop syllabus. 4.2 To prepare training materials for the workshop. 4.3 To flesh out the logistics to deliver the workshop course. 4.4 To hire the workshop-course teachers. 4.5 To acquire food services for participants of the training process. 4.6 To run the workshop course. (3 hours / day, 3 times / week, total 72 hours) 4.7 To evaluate the formation process of the three courses.

07/01/13

09/27/13

07/22/13 07/29/13

07/26/13 08/09/13

07/22/13

07/26/13

08/12/13

08/23/13

08/12/13

08/23/13

09/30/13

11/29/13

11/25/13

11/29/13

13. Contractors, subcontractors, consultants and experts:

Please list the diverse contractors, subcontractors, consultants and/or experts who will participate in the implementation of the activities of the proposed programme/project who are not employed by your organization. Please indicate each persons specific field of competence, role(s) and responsibility(ies), as well the reason(s) for which the applicant is calling upon their intervention. All paid interventions must be reflected in the budget.

Indicate whether: the contractor, subcontractor, consultant or expert field experience, role(s) and responsibility(ies), reason(s), subcontractor, consultant or expert is being engaged

The Ministerio de Cultura y Juventud will hire the expert personnel to undertake this project, prioritizing the local human resources. Indicate whether: contractor, Field of expertise, role(s) and
subcontractor, consultant or expert responsibility(ies)

Reason contractor,
subcontractor, consultant or expert is being engaged

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14. Expected results:

Please use the table below to clearly indicate the expected results of your programme/project and indicate how you will know whether such results have been achieved. The expected results should be concrete and measurable and will serve as the base for the evaluation of the programme/project after its completion. The results should be correlated with the objectives, activities and budget, described in sections 9, 11 and 16 respectively, including those that pursue the promotion of gender equality. The number of expected results must match the number of activities listed under section 12.

Expected Results

Indicators

Means of verification

1.1 A work team (three people) formed to efficiently implement the project. 1.2 Management plan of the projects implementation.

Number of staff employed by Record file of the hiring the number of staff scheduled to process, Institutional be hired times one hundred. Procurement and Ministers Office. Number of plans activities carried out, among the many activities scheduled in the plan, per times one hundred. . Record file in the Office of the Minister and in the Department of International Cooperation. During the project, an evaluation will be held to control the level of actual progress of the project.
Archivo del Despacho Ministerial and the Departamento de Cooperacin Internacional

2 Three courses given to 60 Caribbean farmers (a group of crafts, another of music, and the last one of gastronomy, each group made up of 20 participants), where they developed their product with a high cultural value. 3 Three courses given to 60 Caribbean farmers (a group of crafts, another of music, and the

2 Number of courses, including the amount of courses programmed times one hundred.

3 Number of courses, including the amount of courses programmed times one

Archivo del Despacho Ministerial and the Departamento de

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

last one of gastronomy, each group made up of 20 participants), in which they developed the design with their products identity. 4 Three courses given to 60 Caribbean farmers (a group of crafts, another of music, and the last one of gastronomy, each group made up of 20 participants), where they developed their skills and business skills.
*

hundred.

Cooperacin Internacional

4 Number of courses, including the amount of courses programmed times one hundred.

Archivo del Despacho Ministerial and the Departamento de Cooperacin Internacional

Indicators are used to measure progress related to an expected result or an aspect of it.

** Means of verification are data sources and methodologies used to measure and analyze performance.

15. Sustainability:
Please explain the expected impact of your programme/project on the emergence of a dynamic cultural sector, on sustainable development and on poverty reduction in your country. Describe the short (immediately following the end of your programme/project), medium (within five years) and long-term (within 15-20 years) conditions that would enable your programme/projects gains to be sustainable. (Max. 400 words)

The project will directly impact the local economy as it is aimed to strengthen the capacities of farmers in craft, music, and cuisine of the Caribbean region of Costa Rica. The giving of knowledge, skills, and abilities to these farmers is improving their products, in terms of production techniques, design, and marketing, and it is also improving the creation of MSMEs that are able to stay and grow in the formal economy. Another important impact is an intangible or a non-pecuniary, such as the preservation of intangible cultural heritage, as these farmers are carriers of knowledge which in turn can be transmitted to others and, thus, ensure the preservation of the Caribbean cultural heritage in these three fields. Moreover, this project represents the starting point of the alliance between the Ministerio de Cultura y Juventud and the INA to create a project to establish a cultural business incubator in the Caribbean region of Costa Rica. This alliance will strengthen the participation of the Instituto Mixto

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

de Ayuda Social (IMAS, translated as Joint Social Assistance Institute), as it can allocate resources for funding for the creation of cultural MSMEs. With the claim that the Caribbean farmer has the ability to live out of their cultural products and make them part of the formal economy, without a doubt will be a positive chain in the local economy, bringing collaterally other indirect beneficiaries of the production process and commercial. It should not be overlooked that, the Port of Limon has great tourist potential, where the products of these farmers have almost a guaranteed market. In the longer term, we tried to teach a new course to the successful recipients of this training process to prepare them as new trainers, so that their experience and knowledge can be transmitted over the Caribbean and new farmers.

16. Budget 16.1 Budget summary: Total funding requested from the IFDC (may not exceed USD100,000): USD 100,000 + Total co/self-funding: USD 52,574 = Total project cost: USD 152,574

16.2 IFCD funding budget breakdown: Please fill in the table below with information on all foreseen expenditure items and their cost in USD for the amount of IFCD funding requested (the total amount of this budget must match the USD figure quoted on the first line of section 16.1). At the end of the programme/project, all original invoices and supporting documents must be sent to UNESCO. A pro forma invoice for equipment will be required.

Budget of the Project

Unit Expenditure 1. Salaries / fees 1.1 Project staff 1,2,3 y 4 Per month 2,000 1 18,000 Results N # of Total units quantity (in USD) Costs (in USD)

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

1.1 Project staff of the Ministerio de Cultura y Juventud (4 person) 1,2,3 y 4 1.2 Experts / consultants 2 1.2 Experts / consultants 3 1.2 Experts / consultants 4 Subtotal salaries / fees 2. Travel and per diem 2.2 Land transportation 2.2 Land transportation 2.3 Acco+35274+modations 2.5 Per diem for domestic missions / trips 2.6 Seminar / conference participants 2.6 Seminar / conference participants

Per month Per of time Per month Per month Per month

750 700 700 700

9 5 2 5

27,000 10,500 4,200 10,500 70,200

1 2,3 y 4 1,2,3 y 4 1,2,3 y 4 2, 3 y 4

Per day Per day Per 3 person Per day Per day Per 65 person Per day

16 16 50 20

12 72 85 80

192 1,152 4,250 1,600 28,080 35,274

6 65 /72day

Subtotal travel and per diem 3. Equipment and supplies 3.2 Equipment (total based on pro forma invoice enclosed with the application) 2,3 y 4 3.3 Other (please specify) supplies 1,2,3 y 4 3.3 Other (please specify) Material of work of the participants 2,3 y 4 Subtotal equipment and supplies 4. Communication 4.1 Publications (editing, design, printing, etc.) Subtotal communication 5. Other costs, services 5.2 Evaluation 5.4 Rent of conference / seminar rooms 5.5 Other (please specify) Subtotal other costs, services 2

Per month Per month Per person

500 200 200

9 9 132

4,500 1,800 26,400 32,700

2,000

6,000 6,000

2,3 y 4 2, 3 y 4

Per month

3,000 600

3,000 5,400

NB: Overhead costs should not make up more than 7% of total direct costs of the programme/project. Total costs 152,574 * See Annex 1 to this Form for a sample budget. ** As a guide, it is advised that overhead costs should not exceed 7% of the total budget. *** Expenditures such as the purchase of a vehicle or construction / renovation of a building are not eligible for IFCD funding.

16.3 Total project cost breakdown: If the funds requested from the IFCD will only cover a portion of a larger programme/project, please provide the provisional budget for the entire programme/project by filling in the table below with information on all foreseen expenditure items and their cost in USD. Please specify the amount that will be IFCD, self or co-funded. In the case of co-funding, please indicate whether or not additional resources are already available or when they are likely to become available and by whom. Written confirmation of co-financing may be requested.

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Budget According to Source of Financing Expenditure 1. Salaries / fees 1.1 Project staff 1,2,3 y 4 1.1 Project staff of the Department of Culture and Youth (4 person) 1,2,3 y 4 1.2 Experts / consultants 2 1.2 Experts / consultants 3 1.2 Experts / consultants 4 Subtotal salaries / fees 2. Travel and per diem 2.2 Land transportation 2.2 Land transportation 2.3 Acco+35274+modations 2.5 Per diem for domestic missions / trips 2.6 Seminar / conference participants 2.6 Seminar / conference participants Subtotal travel and per diem 3. Equipment and supplies 3.2 Equipment (total based on pro forma invoice enclosed with the application) 3.3 Other (please specify) supplies 3.3 Other (please specify) Material of work of the participants Subtotal equipment and supplies 4. Communication 4.1 Publications (editing, design, printing, etc.) Subtotal communication 5. Other costs, services 5.1 Studies, surveys (purchase of data) 5.2 Evaluation 5.3 Translation, interpreters 5.4 Rent of conference / seminar rooms 5.5 Other (please specify) Subtotal other costs, services Total 2 18,000 27,000 10,500 4,200 10,500 70,200 1 2,3 y 4 1,2,3 y 4 1,2,3 y 4 2, 3 y 4 192 1,152 4,250 1,600 28,080 35,274 18,000 27,000 10,500 4,200 10,500 39,000 192 1,152 4,250 1,600 28,080 35,274 0 4,500 2,3 y 4 1,2,3 y 4 2,3 y 4 4,500 1,800 20,000 26,400 32,700 6,000 6,000 20,000 6,000 6,000 6,300 1,800 6,400 31,200 Results N Costs (in USD) Contribution SelfIFCD Funding

2, 3 y 4 2, 3 y 4

3,000 5,400

3,000 5,400 8,400 52,300

100,000

The self-finance budgetary content is approved by the Legislative on December, according to the budgetary process established by our country.

17. Non-financial contributions. If any, of what kind and from what sources?

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

18. Previous funding from UNESCO for similar or related programmes/projects: If you have ever received any funds from UNESCO (either from Headquarters, a Field Office or an Institute) to implement (a) programme/project(s) similar to or related to the project that you are currently proposing, please provide below detailed information on its title, period, contract number, funding source, etc. (Max. 400 words)

19. Contact person for correspondence: Title (Ms/Mr, etc.): Family name: Given name: Position(s): Complete mailing address: Telephone number: Fax number: E-mail address: Other relevant information: Ms

Herrera Loaiza Ana Lorena Head of Departamento de Cooperacin Internacional

Ministerio de Cultura y Juventud, San Jos Costa Rica, entre las calles 11 y 15 y las avenidas 3 y 7

(506) 2258-2251 (506) 2258-2251

cooperacioncultura@yahoo.com

20. Commitment to submit a report on the execution of the programme/project: As stated in paragraph 18 of the Guidelines on the use of the Fund: The applicants shall submit a mandatory descriptive, analytical and financial report on the execution of the programme/project and the realization of expected results. The report must be presented to the Secretariat six months after the conclusion of the programme/project as foreseen within the time frame. No financial contributions for new projects will be allocated to applicants who have not submitted this report. The full text of Article 18 is available at: http://www.unesco.org/culture/culturaldiversity/article18_en.pdf XX XX I commit to respect the provisions of paragraph 18 of the Guidelines. I certify that all information contained in this application is truthful.

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12/06/28 Date

Ana Lorena Herrera Loaiza Head of Dpto. Cooperacin Internacional Name and title

Stamp and signature of the applicant

NB: This application is not valid and cannot be accepted by the UNESCO Secretariat unless it is signed.

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

Annex 1: Sample budget

You may wish to use the suggested budget model below. Please note, however, that you should only use the sections relevant to your programme/project and adapt it as necessary. Expenditure 1. Salaries / fees 1.1 Project staff 1.2 Experts / consultants 1.3 Administrative / support staff Subtotal salaries / fees 2. Travel and per diem 2.1 Air transportation 2.2 Land transportation 2.3 Visa fees 2.4 Per diem for international missions / trips 2.5 Per diem for domestic missions / trips 2.6 Seminar / conference participants Subtotal travel and per diem 3. Equipment and supplies 3.1 Rent of vehicle(s) 3.2 Equipment (total based on pro forma invoice enclosed with the application) 3.3 Other (please specify) Subtotal equipment and supplies 4. Communication 4.1 Publications (editing, design, printing, etc.) 4.2 Press conferences 4.3 Other promotional activities, events, advertisements, etc. (please specify) Subtotal communication 5. Other costs, services 5.1 Studies, surveys (purchase of data) 5.2 Evaluation 5.3 Translation, interpreters 5.4 Rent of conference / seminar rooms 5.5 Other (please specify) Subtotal other costs, services 6. Overhead 6.1 Rent of office space 6.2 Postage, office supplies, etc. (please specify) 6.3 Other (please specify) Subtotal overhead NB: Overhead costs should not make up more than 7% of total direct costs of the programme/project. Per month Per day/week Per month Activity N Unit # of units Unit rate (in USD) Costs (in USD)

Per flight Per day/week Per person Per day Per day Per day

Per vehicle

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

Total costs

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012

Annex 2: Checklist
Please go through the checklist below prior to submitting the Application Form. General 1 Original signature of the person empowered to sign it on behalf of the applicant. Application prepared in English and/or French (requests in other languages will not be retained). All sections of the application form are filled in, respecting word counts indicated in each section. Expected results correspond to the main activities. Detailed budget breakdown is provided in USD and by type of expenditure. Electronic format of the proposal is prepared in standard .rtf or .doc format. Application to be sent both electronically and by post to the National Commissions.

3 4 5 6 7

Annex 3: Evaluation Grid (for information)

Evaluation criteria Relevance/appropriateness of the project to the fields of activity of the IFCD Feasibility of the proposed programme/project Expected results Potential impact Levels of funding requested from the IFCD Score (number of points) from 0 to 4

from 0 to 4 from 0 to 4 from 0 to 4 from 0 to 4

4 3 2 1 0

meets entirely the criteria established by the Conference of Parties and the Intergovernmental Committee addresses the majority of the criteria addresses half of the criteria addresses less than half of the criteria does not address the criteria at all

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International Fund for Cultural Diversity - Application Form for Programmes/Projects - 2012