Name of Institution (please print):
Name of Head of Institution: Mr. __ Mrs. __ Ms. __
Position: / Head of Institution E-mail:
Person Completing Action Plan Form: Mr. __ Mrs. __ Ms. __
Position: / Personal E-mail: / Skype:
Institution Postal Address:
City/State: / Postal Code: / Country:
Phone (with country and city code): / Ph 1: / Ph 2:
Fax: / Institution E-mail:
Website: / Date: / (DD/MM/YYYY)

The purpose of the Institutional Action Plan (IAP)

The Institutional Action Plan (IAP) is an important tool for several reasons. First, it outlines a common set of strategic objectives, targeted towards supporting the fulfillment of the Summit’s goals, for institutions to use in considering how they wish to contribute to this work. Second, it creates an easy, uniform way for institutions to report on and share their plans and accomplishments.

It is not expected that every institution will undertake every objective outlined on the IAP. Each institution has its own mission and mandate—a mission or mandate that may or may not significantly overlap with the goals of the Microcredit Summit. It is hoped that completing an IAP may initiate a course of debate and reflection within an institution.

The Institutional Action Plan is meant to facilitate a process in which each institution can determine for itself the degree to which it will undertake projects that address the Summit’s core themes:

·  Reaching the poorest families (defined as families in developing countries who are in the bottom 50% of the population living below their country’s poverty line, or those families living on less than $1.25 a day per capita, purchasing power parity, and families in industrialized countries living below the poverty line)

·  Reaching and empowering women

·  Building financially self-sufficient institutions

·  Ensuring a positive measurable impact on the lives of clients and their families

For more information on these core themes, see http://www.microcreditsummit.org/about/about_the_microcredit_summit_campaign/

For the purposes of the Microcredit Summit Campaign, any reference to microcredit should be understood to refer to credit for self-employment and other financial and business services (including savings and technical assistance) for the poorest.

Instructions for submitting

Council members are asked to revise and resubmit their IAP every year. We ask that you submit your 2013 Institutional Action Plan to the Microcredit Summit Secretariat by Friday May 31, 2013. Your IAP can be sent as an e-mail attachment to: , or by fax to: 1 202 466 1396, or by mail to: 1730 Rhode Island Ave., NW, Suite 400, Washington, D.C. 20036.

Institution Name: / Country:

Part I: Mainstreaming Microcredit Summit Campaign core themes within the network

Please indicate the status of the following policies by Select the appropriate boxes.

Strategic Objective / As of 31 December 2012 /
1a. / Implementation, by network affiliates, of poverty measurement tool(s) to identify the poorest[1] clients in the developing world. / Yes / No / ID[2]
1b. / Implementation, by network affiliates, of poverty measurement tool(s) to identify the poor[3] clients in the industrialized world. / Yes / No / ID
1c. / What poverty measurement tool was developed and/or used, by network affiliates (e.g., estimate, CASHPOR House Index, Participatory Wealth Ranking, CGAP/IFPRI Poverty Assessment Tool, other)
2. / Adoption, by the network, of benchmarks that measure the financial self-sufficiency of network affiliates. / Yes / No / ID
3. / Adoption, by the network, of a goal to reach a certain percentage of women clients being served by network affiliates. / Yes / No / ID
4a. / Specification and/or monitoring of social indicators (especially movement out of poverty) as measurement of the impact of network affiliates. / Yes / No / ID
4b. / What impact measurement tool was developed and/or used by network affiliates (e.g., AIMS, estimate, other).
5. / Encouragement of network affiliates, by the network, to complete Institutional Action Plans and to submit them to the Summit Campaign. / Yes / No / ID

Part II: Education and Advocacy

Strategic Objective / As of 31 December 2012 /
6. / RESEARCH

Have you done or will you do research on microcredit, related to the Summit’s core themes?

/ Please Select One: Yes __ / No __ / PIF[4] __
If yes, when do you expect to release it?
Topic:
· 
7a. / ADVOCACY
Have you or will you encourage/pressure your government to provide financial support to microfinance institutions which serve the poorest people, especially women, and which strive for self-sufficiency? / Yes __ / No __ / PIF __
Yes, we encouraged/pressured our government to provide financial support for microfinance institutions which:
__ Serve the poorest people in developing countries
__ Serve poor people in industrialized countries
__ Reach and empower women
__ Strive toward financial self-sufficiency
__ Have a positive measurable impact on lives of clients and their families
Institution Name: / Country:
Strategic Objective / As of 31 Dec. 2012 /
7b. / Have you or will you encourage/pressure your government to create a favorable policy environment for microfinance institutions and very poor micro-entrepreneurs? / Yes __ / No __ / PIF __
If yes, give one example of a change you are seeking:
· 
8. / PUBLIC EDUCATION
Have you done or will you do public education on microcredit as a poverty alleviation tool?
If yes, how many people and what kinds of organizations do you intend to educate? / Yes __ / No __ / PIF __
We have reached this number of people: ______
__ Government
__ Banks
__ Foundations
__ Educational Institutions
__ Other______
By what means?
· 
9. / TRAINING
Have you or will you offer training to microcredit institutions on good practice, addressing the Summit’s core themes? / Yes __ / No __ / PIF __
Yes, we offered training on good practice in these areas (Please attach a brochure or other materials describing the training you offer):
__ Identifying and serving the poorest people in develop ing countries
__ Identifying and serving poor people in industrialized countries
__ Reaching and empowering women
__ Working towards financial self-sufficiency
__ Measuring and ensuring impact on lives of clients and their families
10. / SEAL OF EXCELLENCE
Would you like to learn more about the Seal of Excellence for Poverty Outreach and Transformation in Microfinance? / Yes __ / No __ / PIF __
The Seal of Excellence for Poverty Outreach and Transformation in Microfinance is a global initiative currently under development that will recognize those institutions doing the most to help families lift themselves out of poverty. Sam Daley-Harris first had the idea for the Seal in April 2010 in response to his concern that microfinance was going down the path of for-profit institutions and abandoning its founding mission to help the poor. The Seal has been under development for the past 2 years with input from a broad range of stakeholders and will continue in 2013.
Our movement is not just about money, it is about unlocking human dreams. We seek to employ financial capital to unleash human potential, and we still have a lot to learn from those who do this well.
11. / OTHER
Are there other projects in support of the Campaign’s goals that you are planning, such as enlisting new advocates and other council members? / Yes __ / No __ / PIF __
If yes, briefly describe:
· 
__ Please send me Microcredit Summit Campaign outreach materials so that I can enlist new council members.
Institution Name: / Country:

Part III: Member Institutions

(Please fill in the table below with a list of your members including the name of a contact, and their phone and email address, or attach the list separately. If you need additional space, please attach additional pages to your IAP.)

Institution Name / Contact Name / Phone Number (including country and city code) / Email Address
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

[1] The “poorest” in developing countries refers to families whose income is in the bottom 50 percent of the population living below their country’s poverty line, or those families living on less than $1.25 a day per capita, purchasing power parity.

[2] ID = In Development

[3] In industrialized countries the poor are those families who are living below their nation’s poverty line.

[4] PIF = Perhaps In the Future.