"Hestia" Onassis International Prize 2010

Application form for the "Hestia" Onassis
International Prize 2010 in Immigrant
Integration and Human Development

Please answer the following questions with as much information as you can provide. All information provided will be kept confidential, and will only be used by the Hestia Prize Committee and the Global Forum on Migration and Development (GFMD) Civil Society Days (CSD) subcommittee of the International Advisory Committee 2010 for the purpose of selecting participants.

Please indicate whether you will allow us to share your contact information with other interested parties who may wish to contact you:

My contact information (name, position, organization, address, telephone and fax number, e-mail address) can be shared with other participants and organizations involved in the GFMD CSD strictly for contact and information purposes involving the GFMD CSD and related activities.

I agree I do not agree

I hereby declare that all information provided to the Onassis Foundation in relation to the purpose of the "Hestia" Onassis International Prize is true and complete.

Please do not proceed if you have not completed and signed the previous box.

Before completing the application form,
please consult the CALL FOR APPLICATION

CALL FOR APPLICATION

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Please complete the application in capital letters.

(*) The asterisk indicates compulsory fields

1. Applicant details

For civil society organizations, associations or group of citizens

Title of the civil society organization, association or group of citizens *
Full name and acronym of organization (if applicable)
Year established *

Application submitted by (contact person) *:

Title *
First Name *
Middle Name
Last Name *
Position in the civil society organization, association or group *

For individuals or a group of individuals

Title *
First Name *
Middle Name
Last Name *
Group Name (if applicable)
Position (if applicable)

2. Contact details

Mailing address *
Area / City / Province *
Postal code *
Country *
Contact tel. number *
Mobile tel. number
Facsimile number
E-mail address *
Website

Gender of applicant or contact person *

3. Identity of the candidate project

Title of the project *
Duration of the project * From:
To:

Project overview. Please provide a summary of the initiative/project describing aim, activities realized, results and wider impact

Aim *
(No more than 100 words)
Activities realized *
(No more than 100 words)
Results *
(No more than 100 words)
Wider impact *
(No more than 100 words)

Self-evaluation of your initiative/project based on the four Selection Criteria described in the Prize’s brief (importance, innovative approach, impact, influence)

Importance *
(No more than 100 words)
Innovative approach *
(No more than 100 words)
Impact *
(No more than 100 words)
Influence *
(No more than 100 words)

Please provide us with a full description of already received funding until today (voluntary contributions, government funds, EU funds, UN funds, other) (up to 5 most recent funds received, if applicable)

Funding Until Today

Funding organization
Amount
Currency
Time Period From:
To:
Name of project/activity funded

Please provide us with details for the funding you have already secured for the next 3 years (2011 – 2013), if applicable.

Future Funding

Funding organization
Amount
Currency
Time Period From:
To:
Name of project/activity funded

Are you planning to continue your project? *

yes no

If the answer to the above question is YES, for how long?

Please attach 2 reference persons (preferably one from the local community of your activities, and a government official, policy maker or politician) who know your work and your project in migrant integration and human development and who, if required, may be contacted by the Foundation.

First Reference person: *

Title *
First Name *
Middle Name
Last Name *
Position *
E-mail address *
Contact tel. number *

Second Reference person: *

Title *
First Name *
Middle Name
Last Name *
Position *
E-mail address *
Contact tel. number *

Please provide us with at least 1 testimonial of participants in the programme

Testimonial of participants *
(No more than 100 words)

Can we visit your headquarters? *

yes no

Please attach any supporting material upon your judgment (pictures, testimonials, annual reports, etc.) in form of word document, excel, jpeg, pdf, gif, png files.

Please also attach the names and brief CVs of the project team and team leader(s), if applicable.

IMPORTANT NOTES

Please note that the application and all supporting material should be in English or Spanish only.

Please note that the application and all supporting material must not exceed the 8 MB.