OMB No.

0142-0585
Expiration Date: 09/30/2016

Feed the Future Public-Private Partnership Opportunity Explorer

Complete this form* to indicate your organization’s interest in a public-private partnership with Feed the Future
and connect with the right person to help you continue the exploration process.

First Name:* v Last Name:*

Organization:* v Position:*
Work Email:* v Work Phone:*
Who else has your organization contacted at USAID or partnering Feed the Future agencies?*
v

What type of partnership is your organization interested in? (Please select all that apply. For information on each,
click here)
Embed within an existing program Collaboration agreement Other
Competitive grant Loan guarantee Please indicate:

Is your organization currently in partnership with any U.S. Government agency? Yes No
(If yes, please select all that apply)
USAID Peace Corps
U.S. Department of State Overseas Private Investment Corporation
Office of the U.S. Trade Representative
U.S. Department of Agriculture
U.S. African Development Foundation
U.S. Department of the Treasury Other
Please indicate:
Millennium Challenge Corporation

Has your organization been in partnership with any U.S. Government agency in the past? Yes No
(If yes, please select all that apply)
USAID Peace Corps
U.S. Department of State Overseas Private Investment Corporation
Office of the U.S. Trade Representative
U.S. Department of Agriculture
U.S. African Development Foundation
U.S. Department of the Treasury Other
Please indicate:
Millennium Challenge Corporation

Sectors
In which Feed the Future sectors does your organization want to work?* (Select all that apply. For more
information on each, click here)
Science & technology Risk mitigation Nutrition education
Capacity building Policy reform Nutrition services
Research and extension services Pre-harvest market efficiency Other
Environment and natural resource management Improved market function Please indicate:
Financial services Reduced post-harvest loss

AID 101-1 (09/2013) Page 1 of 2

 Resources
What resources can your organization bring to a partnership? (cash, in-kind)* (Select all that apply. For more
information, click here)
$250,000, 25% of which is cash Technology
Commodities Communications and capital assets
Use of training or other purpose-specific facilities Intellectual property rights
Time donated by technical consultants Other
Staff dedicated to project Please indicate:

Countries
In which Feed the Future country does your organization want to work?* (Select all that apply. For information on
each country, click here)
Bangladesh Kenya Senegal
Cambodia Liberia Tajikistan
Ethiopia Malawi Tanzania
Ghana Mali Uganda
Guatemala Mozambique Zambia
Haiti Nepal Other
Honduras Rwanda Please indicate:

If you have a concept note, white paper or a couple of paragraphs to explain more about your organization’s
partnership idea, please include it with this form.

*required field
Please check this box if your organization considers the information it is providing on this form to be privileged or
confidential commercial or financial information that your organization does not intend to disclose to the public.

*Please note that federal agencies may not conduct or sponsor a collection of information, nor are you required to
respond to one, unless it displays a valid OMB control number. The valid OMB control number for this information
collection is 0412-0585. All responses are voluntary.

We estimate that it will take approximately 15 minutes per response for you to review and complete this form. If
you have comments or suggestions about the form, please send us an email at ftfbusinesshub@usaid.gov.

To submit this form, please email or fax to the Bureau for Food Security at the U.S. Agency for International
Development: ftfbusinesshub@usaid.gov or 202-216-3121

AID 101-1 (09/2013) Page 2 of 2