UGSA 2021 Application Form

Download the form here UGSA-Form 2021

 

UGANDA TEXTBOOK ACADEMIC AND NON-FICTION AUTHORS ASSOCIATION (UTANA)

UTANA GRANT SCHEME FOR AUTHORS (UGSA) PROJECT

APPLICATION FORM

This Grant is open to authors of Academic and non-fiction works in Uganda. The Grant is available for only registered members of UTANA. Non-UTANA members are therefore required to send their membership application form together with this form. The completed and signed application should be submitted in Confidence to the Coordinator, UTANA Grant Scheme for Authors (UGSA), +256-772495592/0706495592, [email protected] OR in a sealed envelope strictly marked UTANA GRANT SCHEME FOR AUTHORS (UGSA) Project, UTANA Office, 2nd Floor, Teachers House, Bombo Road.

Section A: Particulars of Application

  1. NAME of Author(s):

 

  1. Membership status (tick appropriately): Current registered member           Potential Member

 

  1. Title of proposed Book (Publication):

 

 

  1. Authorship Details (Corresponding Author/Applicant):

First name(s):                                    Family name:                                                     Sex M/F:

 

Title: Ms/Mr/Mrs/Dr/Prof/Rev                                                                  __________________________

Date of birth:                                                     Landline phone:                                               Mobile:

E-mail address

Organization or institution at which you work (if applicable):

Section B: Manuscript Details

  1. Description of manuscript( Please write a short (500-word maximum) description/summary of the content/manuscript fronted for publication)

 

  1. Target Audience: ———————————————-
  2. Current Level of Manuscript (Select Appropriately):
  3. Still under research
  4. Draft Stage
  5. Writing Stage
  6. Editing Stage
  7. Translation
  8. Design and Production (including e-publishing)
  9. What is left to be done: ____________________________________________________

 

  1. What help do you need to make it ready for Publishing

 

  1. Have you already approached a publisher for the book you are writing?
  2. If Yes, please provide details.
  3. If not, could you say something about how you envisage your book being published and distributed? In either case, please attach a copy of manuscript for evaluation purposes.

 

 

  1. Please provide a budget detailing key items/cost centers/stages of preparation, publication and utilization of the grant. Note this grant applies Result Based financing Model.

 

 

  1. When do you expect to finish writing? How much time do you have to complete the manuscript (Provide a work plan-time schedule?)

 

 

  1. We will not necessarily disqualify an applicant who has also received funds from another source. If you have sought or had funding promised or received funds from other sources, please indicate below is being covered.

 

 

  1. Please briefly provide any other information about yourself and your writing which you think will be helpful to the Selection Committee in assessing your application.

 

Declaration

I hereby declare that I have disclosed all the material facts necessary for this application and that all the information provided is true and correct.

Signature                                                                                                             Date———————-

Names:______________________________________________________________

Thank you. 

For inquiry purposes, please contact, Project Coordinator,  [email protected], 0772495592/0706495592