I

DEMOCRATIC SOCIETY PROMOTION (DSP)

NOMINATION FORM FOR THE

DSP AWARD FOR DEMOCRACY

Nomination
Protocol
Number: / Filled in by KCSF / Date of application (dd/mm/yy): / Filled in by KCSF
”Fazli Greiçevci”55, 10000 Prishtinë, Kosova
+381 (0)38 248 636 | +381 (0)38 248 643
|

GENERAL INFORMATION

Democratic Society Promotion (DSP) is a project funded by the Swiss Cooperation Office in Kosovo (SCO-K) and managed by Kosovar Civil Society Foundation (KCSF). The overall goal of DSP is to support the development of a democratic society in Kosovo by strengthening the civil society, both on the local and central level. DSP provides this support through three main instruments: project grants, institutional grants and awards.

Awardshonour successful initiatives, the work and activities of organizations or individuals who have contributed in the development of a democratic society in Kosovo, in any of the fields where DSP extends its activity.

DSP invites all interested parties to nominate individuals or organizations which they consider have made adistinguished contribution to the democratization of the country.

Nomination Criteria

Who can be nominated?

Civil society actors, including civil society organizations, formal and informal networks, media, academic institutions and individuals who with their work and dedication have contributed to the democratization of Kosovar society, are entitled to be nominated.DSP grantees are also eligible. For-profit entities are not eligible.

Who can nominate?

Nominations may be submitted by any organization, entity or person having accurate and detailed information on the individual’s or the organization’s initiative being nominated.As such,self-nomination is also applicable.

Selection Criteria

All nominations will be reviewed individually and will be evaluated by the Grants and Awards Board (GAB) of DSP,based on one ore the several of the following criteria:

The design and implementation of the initiative (approach, activity, project, etc.) in one of DSP's program areas during the period 2011- 2015;

The innovative nature of the initiative;

The impact of the initiative, including the potential for expansion or replication;

The courage and audacity of the organization or the individual expressed through the initiative;

Nomination Process

To complete the nomination process, make sure to have completed and submitted the following documents:

  1. The nomination formno longer than 7 pages (A4) without annexes,filled in and signed;
  2. A short bio of the nominee or the nominated organization's profile;
  3. Accompanying documents (articles written for the nominee, reference letters, etc.);
  4. For civil society organizations, a copy of the registration certificate. For citizen initiatives, a proof of civic initiative functionality should be provided.[1]
  5. For other entities, a copy of the founding document or any other equivalent document.

Submission of documents

The completed documents must be submitted in person, in a closed envelope with the inscription "For the DSP Award for Democracy", KCSF offices (street "FazliGreiçevci"55, 10000 Prishtina, Kosovo). The envelope must contain the required documents also in electronic format, on a CD.

The deadline for submission ofthe nominations is 15thApril, 2016 at 14:00.

When submitting the application, each applicant will receive a confirmation on the timely receipt of the nomination. Please note that each nomination is to be evaluated independently.

DSP is unable to provide individual responses for those nominations not receiving support. Before summer 2016, successful applicants will be informed on the decision after the full review of the nomination process.In the meantime, candidates are not encouraged to contact KCSF on the status of the nomination.

When submitting this form, please remove the pages2 and 3 with instructions.

DEMOCRATIC SOCIETY PROMOTION (DSP)

NOMINATION FORM FOR THEDSP AWARD FOR DEMOCRACY

Max 1 page

PART I.- Generaldata ofthe nominator:

Name of the organization/personsubmitting the nomination:......

Address: ……………………………………………………………………………………………………………………………………………..

Tel.: ...... E-mail:…………………………………………………………………….

Dateof submission: ………………..

PART II. – General data of the nominee:

If the nominee is an organization or entity:

Full name and abbreviation of the organization or entity:…………………………………………………………………………………………………………………………………………………………….

Organizations or entity’soperating sector:…………………………………………………………………………………………

(Civil society organization, academic institutions, media,civicinitativeetc.)

Main area of activity:…………………………………………………………………………………………......

Address:……………………………………………………………………………………………………………………………………………..

Tel.:………………………………………………………………… E-mail ………………………………………………………………………

Webpage.: ………………………………………………………

If the nominee is anindividual:

Name and surname of the individual:………………………………………………………………………………………………..

Date of birth: ………………..

The organization and position (if applicable):……………………………………………………………………………………

Address:……………………………………………………………………………………………………………………………………………..

Tel.: ...... E-mail: ……………………………………………………………………

PART III. – Information on the initiative

Max 5 pages

1)What isthe main reason for this nomination?

2) Explain the specific initiative the nominee has designed and/or implemented in the period between 2011-2015? (If there is more than one initiative, please provide specific informationfor each of them)

3) What is the impact of this initiative? (If there is more than one initiative, please provide specific informationfor each of them)

4) What do you consider to be innovative in this initiative? Explain the innovative character of the initiative.(If there is more than one initiative, please provide specific informationfor each of them)

5) Has this initiative been repeated or are there any possibilities for its replicationor expansion within the group or the wider geographic region? (If there is more than one initiative, please provide specific information for each of them)

6) How has the nominee communicated with the final beneficiaries of the initiative?

7) Who have been the leading partners and/or supporters of the initiative?

8) Was the initiative supported financially by any donor? If yes, please indicate the name of the donor and the amount of financial support.

9) In general, why do you think the nominee deserves the DSP Award for Democracy?

10) Provide two references for the initiative and the nominee (Name Surname, position, e-mail and telephone number and other contact details). (If needed, these individuals will be contacted to collect further information about the nominee and the initiative)

Please provide answers for each question and DO NOT delete any question.

1

[1]Any document proving the existence of the initiative, e.g: membership list, photos, materials from activities/meetings, etc.