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Please advise if you disagree with any of the following as these must be met in order for your application to be approved and will form the basis of a formal contract for signature:
The Charitable Organisation shall acknowledge the Bank’s contribution in the following manner:
Acknowledgement in naming building or facility and/or placement of plaque reading: the project scope was made possible through the kind generosity of Republic Bank Limited as part of its Power to Make a Difference programme.
Any use of the Bank’s name or logo shall be done with the Bank’s prior approval.
The Charitable Organisation agrees to provide quarterly progress and expenditure reports and complete the project scope within 12 months of commencement.
Failure to complete the project within 12 months of commencement, will result in loss of social investment/sponsorship. The Charitable Organisation will be required to reapply for funding in 2023/24 Fiscal Budget, subject to the Bank’s approval.
The Charitable Organisation in conjunction with Republic Bank will agree appropriate publicity opportunities to maximize the contribution of the Bank.
The Bank shall be allowed to film and photograph the project scope and participants and footage and photographs shall be used by the Bank as it deems appropriate.
The Bank reserves the right to withdraw social investment/sponsorship from the Charitable Organisation if the project scope is not achieved.
Any dispute arising in relation to the terms of the Agreement will be first dealt with by the legal representatives of the parties. In the event that the legal representatives fail to resolve the dispute the parties reserve the right to proceed to Arbitration or to pursue all available legal remedies.
The Charitable Organisation will provide a volunteer orientation for any staff of Republic Bank willing to volunteer for the particular charity.
I agree to the above terms
I would like to further discuss the above terms
If yes, please insert your concerns below
Name of Organisation
Name & Title of Contact Person
Contact's Telephone Number
Contact's Email Address
Secondary Contact's Name & Title
Secondary Contact's Telephone Number
Secondary Contact's Email Address
Please specify your organization type
- Select -
Public Sector Agency
Non-Governmental Organisation (NGO)
Regional/International organization established and operating in Dominica
Does your organisation have charitable status? (Registered NGO Certificate)
State Field of Service
(e.g. medical care, youth literacy etc)
Description of Organisation
List name of Board of Directors or governing body/committee along with positions held
(Including copy of one form of ID)
Title of Project/Programme
Purpose of Project/ Programme
Explain the problem and issues you are addressing in 2-3 paragraphs. Describe your way of solving the problem; you can outline your work by major steps.
Describe what you seek to accomplish.
Time frame for Implementation of the Project/Programme: From
Time frame for Implementation of the Project/Programme: To
Who will benefit from your project? How many people does this programme/project serve? What are the demographics-age group, gender, geographic location, percentage of low to moderate-income people served, etc?)
Describe the criteria for a successful program, how you will measure the effectiveness of your activities, and the results you expect to achieve by the end of the funding period. Measurement may include research, evaluation results, number served, impact on population served, retention, etc…
Total Projected Cost of programme/project
Itemise cost items as far as possible
Revenue from Fund Raising activities
Revenue from other Sources
State name of lending agency, Donations, Other sources of income
Financial Support being requested
Detailed Projected Budget
Contact Person for Supporting Documents
Name & Title
PLEASE ENSURE ALL SUPPORTING DOCUMENTS LISTED ON THE FIRST PAGE ARE SUBMITTED TO
WITHIN 24 HOURS OF SUBMITTING THIS APPLICATION. FAILURE TO DO SO WILL RESULT IN YOUR APPLICATION BEING CONSIDERED AS REJECTED. HOWEVER, APPLICANTS WILL BE ALLOWED TO RESUBMIT WITHIN THE SUBMISSION TIMELINE IN ACCORDANCE WITH THE RULES ABOVE.
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