Form 3-2338 Application Cover Sheet

Application Cover Page

OMB No. 1018-0123
Expiration Date: ;;;;

Page 3 contains instructions for completing this form.

Program:
Project Title:
Project Location (region or protected area/ country):
Project Coordinates (latitude/ longitude):
Proposed Period of Project Activity (mm/yy – mm/yy):
Amount Requested from USFWS:
Applicant’s Contribution:
Other Partner Contributions:
Total Project Cost:

USD
USD
USD
USD

Applicant Organization:
DUNS Number:
Tax ID Number:
Funds should be made payable to:
Provide DUNS if payee is not applicant

Project Manager (provide name, title, organization, phone number,
email and mailing address):

Grant Administrator (If different than Project Manager provide
name, title, organization, phone number, email and mailing address):

Alternate Contact Person:
Name:
Organization:

E-mail:
Telephone:

Partner organizations contributing cash or in-kind support to this project:
Organization
Contribution Amount (USD)

FWS FORM 3-2338
REV 03/11

OMB No. 1018-0123
Expiration Date: ;;;;

The U.S. Fish and Wildlife Service is interested in engaging partners for international wildlife conservation.
To achieve this goal we may share your proposal with qualified organizations or individuals that have the
potential to enhance the proposed conservation effort. If you prefer that your proposal not be shared, please
check this box .

SIGNATURE OF AUTHORIZED REPRESENTATIVE

DATE

NAME OF AUTHORIZED REPRESENTATIVE:
TITLE:

FWS FORM 3-2338
REV 03/11

OMB No. 1018-0123
Expiration Date: ;;;;

APPLICATION COVER PAGE INSTRUCTIONS
Program Name:

Project Title:
Project Location:
Project Coordinates:
Proposed Period of Project
Activity:
Amount Requested from FWS:
Total Applicant Contribution:
Total Partner Contributions:
Total Project Cost:
Applicant Organization:
DUNS #:

TIN #:

Funds should be made payable to:

Select program name from the drop down box or, if completing a printed form, insert the name of
the grant program under which you are submitting your application. The programs are: African
Elephant Conservation Fund; Asian Elephant Conservation Fund; Great Ape Conservation Fund;
Marine Turtles Conservation Fund; Rhinoceros and Tiger Conservation Fund; and Wildlife Without
Borders-Africa, Latin America & the Caribbean, Mexico, Amphibians In Decline, and Critically
Critically Endangered Animals.
Project title should reflect the nature of the work to be performed, and include specifics on the
location and country where the work will take place.
List either the protected area or region in which the project will take place.
Enter the latitude and longitude of the project site in degrees, minutes, seconds. If there are multiple
project sites, identify coordinates for the primary site or project headquarters.
Enter the month and year of the start and end of the project.
State the amount being requested from the FWS (in U.S. Dollars)
State the amount your organization will contribute to the project (in U.S. Dollars)
State the sum total of all contributions from other partners (in U.S. Dollars)
This is the sum of the three amounts listed above (in U.S. Dollars)
This is the organization or individual submitting the application.
U.S. Governmentwide policy requires all applicant organizations and individuals, both domestic
and nondomestic, to apply for, and include a Dun & Bradstreet Data Universal Number System
(DUNS) number on their application. Applicants without a DUNS number should go to
http://fedgov.dnb.com/webform/pages/CCRSearch.jsp. You will be prompted to select your country
and then search the database for your organization/name. If your organization/name is not found,
you will be routed to a web page that allows you to select “Request a New D-U-N-S Number”.
Follow the instructions for obtaining a new number. Applicants who already have a DUNS number
are responsible for updating changes to their address or business name with Dun and Bradstreet
directly. The organizational address to be used in the event an award is made must match the
information in Dun & Bradstreet’s system. An application will not be considered eligible for
funding until the applicant provides a valid DUNS number.
Tax Identification Number. Required for all U.S.-based organizations. If you are located outside
the United States and do not pay employees within the U.S., you are not required to provide a
Taxpayer Identification Number.
This is the name of the organization or individual who will receive payment from the U.S. Treasury
in the event of an approved grant. In most cases, the organization or individual listed here should be
the same as the Applicant Organization listed above. Other organizations or individuals are not
typically permitted to receive funds on behalf of the Applicant Organization without appropriate
justification and verifiable written approval from the Applicant Organization.

Project Manager:

The Project Manager is the primary person responsible for overseeing the project activities, and can
be contacted for technical, biological, or other questions related to the proposal. Provide: Name;
Title; Organization; Mailing Address*; City/Province/State/Country; Zip/Postal Code; Telephone
number (include country and city code, if applicable); Fax number; and E-mail address.

Grant Administrator:

In the event an award is granted, the Project Administrator is the person who will receive all grantrelated documentation from FWS. If the Grant Administrator will be someone other than the
Project Manager provide: Name; Title; Organization; Mailing Address*;
City/Province/State/Country; Zip/Postal Code; Telephone number (include country and city code, if
applicable); Fax number; and E-mail address.
*The mailing addresses you provide must accept delivery of express/courier mail
(DHL/FedEx/Airborne Express). Typically express/courier mail is only deliverable to an actual
street address. Do not provide a P.O. Box unless your in-country courier service will deliver
express/courier mail to your P.O. Box.

Alternate Contact Person:

The Alternate Contact Person should be available in the absence of the Project Manager and should
be familiar with the project activities. For Alternate Contact Person provide their name,
organization, telephone, and e-mail address.

Partner organizations:

List each partner organization name and amount of cash and/or in-kind support to be contributed to
FWS FORM 3-2338
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OMB No. 1018-0123
Expiration Date: XX/XX/2014

this project. Amounts should be listed in U.S. Dollars. The total of these contributions should equal
the amount under Total Partner Contributions above.
Signature:

Cover page must include the signature of your organization’s authorized representative. Below the
signature and the date, include his/her full name and title.

NOTICE
In accordance with the Paperwork Reduction Act (44 U.S.C. 3501), please be advised that:
1. The gathering of information from potential grant recipients is authorized under Section 8 of the Endangered Species Act of
1973, as amended (16 U.S.C. 1531-43, the African Elephant Conservation Act (16 U.S.C. 4201-4203, 4211-4214, 4221-4225,
4241-4246); the Rhinoceros and Tiger Conservation Act (16 U.S.C. 5301-5306); the Asian Elephant Conservation Act (16
U.S.C. 4261-4266); the Great Ape Conservation Act (16 U.S.C. 6301-6305); and the Marine Turtle Conservation Act (P.L.
108-266).
2.

The submission of requested information is required for all entities competing for financial assistance awards under the Wildlife
Without Borders Programs and the Multinational Species Conservation Funds.

3.

You are not required to respond to a collection of information unless it displays a currently valid OMB control number.

4.

This information collection has been approved by OMB and assigned control number 1018-0123.

5.

The requested information may be subject to disclosure under provisions of the Freedom of Information Act (5 U.S.C. 552).

The public reporting burden for the information collected on this form is 1 hour. This burden estimate includes time for reviewing
instructions, gathering data, and completing and reviewing form. The public reporting burden for completing a full proposal is 21
hours, which amounts to a total estimated time of 22 hours to fully respond to this information collection.

FWS FORM 3-2338
REV 03/11