RSPO Smallholders Engagement Platform - RSPO Smallholder Engagement Form

RSPO Smallholder

Engagement Form

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Smallholder Engagement Form

Request for Support

If you’re looking for support with your smallholder project, please fill out the form below. This is to ensure the relevant information will be featured on the platform.

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Submission Successful

NOTE: Applicants are advised to refer to the RSSF Funding Request Application Guidelines document when filling up this form.

1. General Contact Information

Name of the Smallholder Group Supported*

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Contact Person Name*

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Position within the Group*

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Full Address*

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Country*

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Region / State*

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Telephone*

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Mobile Phone

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Email*

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Website*

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2. Project: General Information

Is the Project Funded by the RSSF

Yes No Invalid Input

Country*

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Region / State*

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GPS Coordinates

(Indicate GPS coordinates if possible)

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Brief Description of Project

(Max 500 words)

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Expected Outcome

(Max 500 words)

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Key Perormance Indicators (KPIs)

(Max 500 words)

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Project Periods :

Start Date

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End Date

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Status of the Project

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Number of Smallholders Benefitted by this Project *

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Type of Smallholders Supported by this Project*

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If Other, Please Explain

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Number and Percentage of Women Supported by this Project :

Number

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Percentage

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Total Area covered by the Project

(in hectares)

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Average Smallholder Yield (Indicate in FFB/ha/year) :

At Project Start

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Current Yield

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Project End

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Project Certification Status

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Do you have Co-Partners Supporting you now?

Yes No Invalid Input

Names and Contact Details of Current Partner Organisations (where relevant)

(Indicate Role: Funding, Implementing, Capacity Building, Supply Chain Partner, Certification, Assessments e.g. SEIA , HCV and Other)

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5. Additional Project Information (Optional)

Smallholder Story / Quote

(You may attach additional documents and image for your story) (Max 500 words)

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Attach a high-resolution photo

(Max 5MB file-size)

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Lessons Learnt

(What worked well or didn’t work well in the project) (Max 1000 words)

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Relevant Tools used for Project Implementation

(Max 500 words)

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Other Information as Deemed Relevant by the Organisation

(You may attach additional documents, example: report, flyer, certificate, newspaper, etc. Please list Annexes here.)

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Attach a high-resolution photo

(Max 5MB file-size)

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Privacy Confirmation

Can the information which you have provided made public?

(Please note that if you say No, the information will only be shown to registered users of this website)

Yes No Invalid Input