MEDIA - TRAINING

CALL FOR PROPOSALS
EACEA/16/09

APPLICATION FORMS

SUPPORT FOR THE NETWORKING AND MOBILITY OF 
STUDENTS AND TRAINERS IN EUROPE

Decision no 1718/2006/CE 
of the European Parliament and of the Council

INTRODUCTION

Before completing the application form, please make sure you have read the Guidelines. The Education, Audiovisual and Culture, Executive Agency ("The Agency") will not consider applications, which do not provide all the information and documents requested. In the same way, applications which do not comply with the eligibility criteria will not be considered for evaluation. 

Particular attention should be given to the Financial part of the Guidelines. Any costs presented in the budget which do not comply with the Financial part of the Guidelines will be considered as ineligible and will not be taken into account when calculating the support to be awarded.

Please respect the format provided and follow the page order. If you need to include more information, do it by way of an annex, although annexes are not to be used as a substitute for completing the appropriate sections in the form. The form is available on the Internet at the following address: http://ec.europa.eu/media  

The procedure to be followed to submit a proposal is explained as in section 12 of the Guidelines. 

Receipt Acknowledgement 

This page will be returned to you once the Agency has received your application. Please therefore complete the information below clearly (coordinator details only):

Full Legal Name of applicant coordinator:	

Title of the action:	

Street & N°:                             	
City : 	

Postcode :	
Country:	

Tel: + 	
Fax: +	

E-mail : 	

Contact person : 	

Date you sent in the proposal:	
…………/…………./………….	

Reserved to the Agency:

We acknowledge receipt of your application within the framework of the Call for Proposals 16/2009.

Reference: 

Date of postmark:
	
…………/…………./………….	

Please use this reference number in all communication with the Agency.

CHECKLIST

Please use this checklist to ensure that you attach all of the necessary documents and sign below. Applications failing to supply the necessary documents will be considered as ineligible.

I.	Official forms:

 	Receipt acknowledgment and checklist duly completed and signed
  	Application forms I to X duly completed 
	Please make sure that all signatures and stamps required on application forms I, III, V, VIII and IX have not been forgotten.

II. 	Information on the applicant coordinator (annex A):

	Copy of all documents officially establishing the company, together with any subsequent amendments.

III.	Information on the financial capacity of the applicant coordinator (annex B – if applicable only): 

	Complete annual accounts (balance sheet, profit and loss accounts and relevant annexes) of the applicant coordinator for the last year available if it is a non-profit organisation (for the last 2 years available if the applicant co-ordinator is a commercial company).
	For proposed actions where requested grants exceed EUR 500 000: an external audit report certifying the accounts, produced by an approved auditor.

IV.	Information on the operational capacity of the applicant consortium (annex D): 

	Job description of staff members involved (or to be involved) in the proposed action

V.	Information on the proposed action (annexes C and D): 

	A detailed course timetable
	A list of all trainers and tutors involved in the proposed action 
	A brief description of their professional background.
      Letters of commitment to the proposed action by tutors / trainers already confirmed

VI.	Estimated budget and financial plan:

	Estimated budget and Note to the budget 
	Financing plan – table of sources of income 
	Statements of partnership of all financial contributors involved (Application form points VIII and IX) 
	If applicable: a copy of the VAT registration for the applicant coordinator (annex E)

Name of legal representative: 		Position in the organisation: 		
Signature of legal representative:		Date: .........................

I – Declaration of Honour

The applicant coordinator [organisation name] certifies:

•	that it is not in one of the exclusion cases listed in section 6 of the guidelines of Call for Proposals 16/2009;

•	that it is a European organisation as defined in the guidelines applicable to this Call for Proposals;

•	that it is familiar with the guidelines “Support for the networking and mobility of Students and Trainers in Europe” of Call 16/2009 of the MEDIA Programme and that it accepts and observes the conditions and procedures specified therein;

•	that the information contained in this application form is true and verifiable;

•	that the person signing this application has been duly authorised by the company to do so;

•	that it agrees with the publication of information about the grant awarded, should its application be successful;

•	that it commits, in case the proposal will be considered for awarding, to inform the Media Desks of the selection of the action and to keep them regularly informed about the progress of the action: dates, venues, names of tutors and participants;

•	that the amounts and details declared in the Budget Summary form are accurate and necessary for the implementation of the action and fall within the definition of eligible costs specified in the financial guidelines relevant to this current Call for Proposals;

•	that, should a MEDIA support be granted and the source of co-financing declared in the provisional budget not confirmed yet, it undertakes to guarantee financial cover for the action; 

•	that it has the financial and operational capacity to complete  the proposed action;

•	that it has read the checklist/annexes and supplied all of the documentation requested;

I am fully aware that the consortium is not entitled to receive more than one grant from the Commission for the action covered by this application and will therefore withdraw any application for any other grant from the Commission should this application be successful, or will withdraw this application should any other application be successful. 

Name of legal representative: 		Position in the organisation: 		
Signature of legal representative:		Date: .........................

 II - Information on the applicant consortium

Information on coordinator only:

Name of the coordinator (full legal title of the organisation) :	
Legal status (public entity, commercial company, association, university etc.)	
Website: 	
Statutory legal representative (name & function)	 	
Authorised signatory for the MEDIA agreement 
(if different)	 	
Registered Office : Street ……………………………………………N°: ……
Post code: ……………….City:……………….…………Country:………………………………	

Correspondence (contact for the follow-up of the file):	
Adress : (if different from legal address)	
tel (office):	fax: 	
tel (mobile): 	e-mail:	
Contact Person Surname and Forename : 
Contact Person Function:	
	
Subsidies granted by a European institution in the course of the last three years (program MEDIA included) and request for subsidy in progress. In this case, specify "in progress" in the column "year of contribution" (if the support is granted, the applicant must inform the program MEDIA of it)	
Name of EU Program	Titre & reference of the project	Year of contribution	Amount (€)	

				

Information on co-beneficiaries (to provide for each partner)

Full legal title of the organisation	
Legal status (association, university etc.):	
Registered office : Street ……………………………………………N°: ……
Post office: ……………….City:……………….…………Country:………………………………	
Official registration number:	
VAT number (if not applicable, please write "N/A")	
Tel :	email :  	
Website: 	
Legal representative / authorised signatory of the organisation:	
Contact Person : 
Contact Person Function:	

Information on each partner (coordinator and co-beneficiaries)

Brief description of the activities of each partner of the consortium. (further information on their organisation, publications or activity reports can be inserted in appendix):

	

IIIa – Financial identification 

Please use the form corresponding to the financial identification of the applicant coordinator according to the country where the organisation is established. The correct forms must be downloaded on the website http://ec.europa.eu/budget/execution/ftiers_en.htm. The applicant must check that all the data included in this form are coherent with the official documents sent

NAME (1) ADDRESS
CITY 
COUNTRY	ACCOUNT NAME	

			

			

			

			

		POST CODE	

		

			
CONTACT			
					
TELEPHONE		FAX			
					
E - MAIL			

	BANK		
BANK NAME			

ADDRESS			
(BRANCH)			
					
TOWN/CITY		POSTCODE			
					
COUNTRY			
				
NUMBER COMPTE			
			
IBAN(2)			

DATE + SIGNATURE ACCOUNT HOLDER :	
(Mandatory)

	
DATE _________________	
BANK STAMP + SIGNATURE OF BANK REPRESENTATIVE
(both mandatory) (3)

Jjjjjjjjjj

   j(1)	The name or title under which the account has been opened and not the name of the authorized agent
 (2)	If the IBAN Code (International Bank account number) is applied in the country where your bank is situated
(3)	It is preferable to attach a copy of recent bank statement, in which event the stamp of the bank and the signature of the bank's representative are not required. The signature of the account-holder is obligatory in all cases.

IIIb – Legal entity form
Please use the form corresponding to the legal form of the applicant organisation according to the country where the company is established. The forms must be downloaded on the website http://ec.europa.eu/comm/budget/execution/legal_entities_fr.htm. 
The applicant must check that all the data included in this form are coherent with the official documents sent. 

SPECIMEN
ORIGINAL FORM TO DOWNLOAD

IV – Proposed action identification sheet

General data on the Action: 

Action title: 		

Timetable for implementing the action
•	Date of start of the action (including preparation) dd/mm/yyyy	
	
•	Date of end of the action (including evaluation & dissemination of results): dd/mm/yyyy	

  The applicant requests that the costs directly linked to the preparation of the action and incurred before the signature of the agreement but not earlier than the 1st of September 2009 be considered as eligible (cf guidelines - section 3). 	

    The applicant requests an extension of the duration of the action beyond 12 months (up to 18 months)

Justification for extension (cf guidelines - section 3) : 

	

-------------------

Specific data on each activity (Repeat this part for each activity included in the Action)

Activity name: 		

Schedule per training activity
•	Total number of sessions part of the activity:
	
•	Number of days by session:
	
•	Dates of the sessions:
	
•	Venue(s) of the sessions:

Content of the activity(ies) (tick box(es) when appropriate)
  Management               
  Development
  New technologies on cinema and television      	

Target group
Type of participants for whom the training activity has been designed: 

Level of education of participants for whom the training activity has been designed:	
Target group :
  Students                        
  Trainers       	

Participants	
Number of participants foreseen :	
Participation fee:
Participation fee includes: ………………………………………………..	
	
Number of trainers working for the project foreseen:                                              
(+ c.v. in Annex D)	
Working language during the activity 
Language/s used in case of translations:	

  V- Information concerning the applicant's financial capacity

Please provide the following information: 
Total eligible costs of the action: EUR …
Amount requested from the MEDIA Programme: EUR …
Other funds already obtained for the action: EUR …
Total number of months of the action (max 12 months or 18 if justified): 

Tick the relevant box for the coordinator of the applicant consortium: 

	The applicant coordinator is a commercial company; therefore the applicant coordinator has enclosed its complete annual accounts for the last 2 years. 
	The applicant coordinator is a non-profit organization; therefore the applicant coordinator has enclosed its complete annual accounts for the last year.
	The applicant coordinator is a public law body and requests to be exempted from the verification of its financial capacity.
	The amount requested to the MEDIA Programme for the action submitted under the Call 16/2009 is less than EUR 25 000; therefore the applicant coordinator requests to be exempted from the verification of its financial capacity.  The applicant certifies through the declaration of honour that it has the operational and financial capacity to implement the action to be granted (Application form I).
Please provide the following information only if your organisation is not exempted from the verification of its financial capacity: 

The annual accounts have been: 
Approved by:
 Board 				 General Assembly		
 Other (please specify)……………………………………………………………………
Date:…………………………………Signed by:……………………....………………….
Position:……………………………………………………………………………………
Certified by:
 an approved auditor external to the company in compliance with the Directive 2006/43/EC of the European Parliament and of the Council of 17 May 2006 on statutory audits of annual accounts and consolidated accounts.
When not exempted, the applicant coordinator must provide the figures requested on the following page, based on the most recent complete annual accounts enclosed with this application (Last year for non-profit organisations / 2 last years for commercial companies) :
	
				Financial Year : …………
				Currency:	   …………

A – NON-PROFIT ORGANISATION ONLY

I – Information to be extracted from the Balance Sheet 

Capital and reserves:								
Total balance sheet :                                         	             						
II – Information to be extracted from the Profit and Loss Account 

Turnover:									 
Depreciation:									
Operating profit or loss:							
Total expenses:								
Profit or loss for the financial year after tax:					 

B – COMMERCIAL COMPANIES ONLY

I – Information to be extracted from the Balance Sheet 

Current assets:								
Current liabilities:								
Capital and reserves:									
Total balance sheet:                                  	       						

II – Information to be extracted from the Profit and Loss Account 

Total expenses	: 								

PLEASE NOTE THAT THE FOLLOWING INFORMATION MUST BE PROVIDED FOR THE LAST 3 YEARS WHEN AVAILABLE: 
							N		N-1		N-2
Depreciation:						 ……		……		…….                                     
Profit or loss for the financial year after tax:		……		……		…….                                     
Dividends:						……		……		…….                                     

Date + name and signature of the Applicant coordinator’s legal representative:

………………………….

VI- Information on the operational capacity of the applicant

Applicant's human and technological resources :

Applicant's experience in organising training activities :

Applicant's international network of contacts in the audiovisual industry :

VII- Summary description of the proposed action

In this section, please provide a summary description of the proposed training activities following the headings hereafter. 

Please provide enough information to enable the evaluation team to get a clear picture of what you intend to do and which results you want to achieve. Additional material (such as brochures, detailed description of training courses, description of the training organisations ...), may be included in annexes.

VII. – point 1. Content of the activity 

Point 8.1 of the guidelines 

VII. – point 2. Project management

This part must cover the following themes (point 8.2 of the guidelines) 
•	Expertise of trainers and tutors involved in the proposed action
•	Methodology
•	Cost effectiveness of the proposed action

VII. – point 3.  Quality of the consortium

This part must cover the following themes (point 8.3 of the guidelines) 
•	Coherence and complementarity's of the consortium
•	Partnership with the audiovisual industry

VII. – point 4. European dimension of the proposed action  

Point 8.4 of the guidelines

VII. – point 5. Impact

Point 8.5 of the guidelines

  

VIII -  DECLARATION BY THE CONSORTIUM PARTNERS

THIS FORM IS TO BE FILLED IN BY EACH PARTNER OF THE CONSORTIUM

NAME OF THE PROPOSED ACTION: ……………………………………………………………………

In the name of the organisation I represent, I hereby declare that I have read and approved the content of the action submitted to the MEDIA Programme. 

Should the action be selected for funding by the EU, I confirm that the organisation I represent intends to contribute to the action with:

•	A financial contribution in cash amounting to: EUR………………………………………

This contribution will be available throughout the duration of the action and all expenditure thereof will be related exclusively to the action.

The organisation agrees, in the framework of the implementation of the action, to make available to the Commission and the Court of Auditors of the European Union, all information relating to the action.

Should the action be accepted, I hereby undertake to clearly mention the MEDIA Programme and the European Union origin of funding in every instance, public or not, official or not, and on all information material.

Name of organisation:

Name of legal representative:

Position of legal representative in the organisation:

Date: 	Place:

Signature (and stamp or present declaration on letterhead)

IX - DECLARATION BY FINANCIAL CONTRIBUTORS

NAME OF THE PROPOSED ACTION: ………………………………………………………………….

In the name of the organisation I represent, I hereby declare that I have read and approved the content of the proposed action submitted to the MEDIA Programme. 

Should the action be selected for funding by the EU, I confirm that the organisation I represent intends to contribute to the action with:

•	A financial contribution in cash amounting to: EUR………………………………………

This contribution will be available throughout the duration of the action and all expenditure thereof will be related exclusively to the action.

Name of organisation:

Name of legal representative:

Position of legal representative in the organisation:

Date: 	Place:

Signature (and stamp or present declaration on letterhead)	

X – Note to the budget	

Please consult section 9 - Financial Conditions of the Guidelines. 

A. Justification of the costs mentioned in the estimated budget

The note to the estimated budget is taken into account for the evaluation of the award criteria, especially for the assessment of the cost effectiveness of the proposed action. The applicants must explain here the reasoning behind the amounts stated in the estimated Budget. 

Please provide us, by way of this note to the budget, explanations and justification of the costs mentioned in each heading of the budget. This will allow us to get a clear picture of the action financial execution. 

1. Personnel = maximum 25% of eligible costs

The applicant must justify the cost per day / number of days stated in the budget for each team member	
	
1.1	Management positions (if already known at submission stage, please identify them nominally and provide the C.V):	 	
1.2	Team members:	 	 			

2. Operational costs :	
	
2.1	Travel and subsistence for team members 	
2.1.1	Travel (destinations and the reason for the trip).	
2.1.2	Subsistence (if necessary, please explain the reasoning behind the estimated expenses)	
	
2.2	Expenses for the training activity(ies) 	
2.2.1	Rental of conference rooms (function and capacity of conference rooms foreseen).	
2.2.2	Equipment (type of equipment foreseen)	
2.2.3	Trainers fees (how the number of days and daily fee per trainer have been decided).    
2.2.4     Didactic material (please describe the support, content and author / provider of material)                                                                                                                                     
2.2.5     Distance learning tools (reasoning behind the estimated expenses)                                                                                                                                            	
2.2.6	Local transport (type of transport foreseen and purpose).	
	
2.3	Travel and subsistence for participants and trainers 

2.3.1 Travel (destinations + differentiate costs for participants and costs for trainers)
	
2.3.2	Subsistence (if necessary, please explain the reasoning behind the estimated expenses)	
		
2.4	Promotion and dissemination of results	
2.4.1	Advertising (detail title and date foreseen for publication) 	
2.4.2	Web pages (identify the provider and describe briefly the content and number of pages).	
2.4.3	Other : to be specified (only for promotion and dissemination of results purposes).	

3. Subcontracting costs	
	
3.1	Translation : specify the languages and reason	
	
3.2	Interpretation : specify the languages and reason	
	
3.3	Print costs: explain briefly what is foreseen	
	
3.4	External accounting services	
	
3.5	Other: to be specified (only for subcontracting costs).	

Overheads = 7% max on budget headings 1+2+3 

B – Costs not mentioned in the estimated budget

For sake of clarity, an explanatory note on ineligible costs (i.e. costs which are not mentioned on the forecast budget – for instance costs covered by contribution in kind) may be added to the note to the budget if the applicant consortium considers that it contributes to a better understanding of its activities by the evaluation committee.

ANNEXES
Please attach all requested annexes and respect the numbering of annexes
Annex A: Evidence of official registration
(c.f.5.1. of the guidelines)

This(ese) document(s) must mention the full legal title, the official registered number, the official registered address, the date and place of registration of the co-ordinator organisation. 

Annex B: Documents giving evidence of the coordinator’s financial capacity 
(c.f.7.2. of the guidelines – to provide only if the applicant coordinator is not a public law body and requests a MEDIA contribution above EUR 25 000).

•	Complete annual accounts (balance sheet as well as the Profit and loss account and relevant annexes) for the last year available if the coordinator of the applicant consortium is a non-profit organisation (2 last years if the co-ordinator is a commercial company). 

•	For proposed action where the EU grant requested exceeds EUR 500 000, the applications must be accompanied by an external audit report produced by an approved auditor. This report shall certify the accounts for the last year available.

Annex C: A detailed course timetable 

The course timetable must be clear, structured and presented in chronological order on an Excel spreadsheet. It should include, when possible, the titles of every lecture / seminar etc. for every training day.

Annex D:  Personnel for the proposed action

a – Director / Manager of the project
•	Clear job description
•	If the Director / Manager is already in place, his / her CV must be attached

b - Staff made available for the proposed action
•	Number and clear job description of staff member foreseen for the proposed action

c - Trainers or tutors made available for the proposed action
•	List of the trainers / tutors involved in the proposed action
•	Curriculum vitae (brief description of their professional background)
•	Letters of commitment signed by the trainers / tutors involved in the proposed action (if they have not confirmed their interest yet, please mention it)

Annex E: VAT registration

•	A copy of VAT registration, including VAT number (if applicable)
•	If the VAT is not deductible and cannot be recovered by the coordinator, please specify it and give evidence of that.