WISE 2011 Invitation Speaker

2015 APPLICATION FORM

The WISE Awards
Recognizing innovative practices
that transform education and society
Organization name:
Project name:
Please read the 2015 Guidelines carefully before submitting your application.
The form should be submitted by January 15, 2015, 13.00 GMT
at

Only applications submitted in English on this official form will be considered. All sections highlighted in gray must be completed, using drop-down menus or free text as appropriate. Fields will expand up to the character limit. When filling out the application form, please make sure that facts and figures are up to date and accurate.

Should problems be encountered in completing the form, please contact the WISE Team through the website or by email:

CHECKLIST
Please review the checklist below before submitting online to make sure that your application is eligible.
I have completed this application form in English.
This project has not been presented by another member of my team/partner organization.
I have not applied for more than one project.
I have included contact details of two valid supporters.
I have read and agree to the terms and conditions, notably that the project may be evaluated during a visit, if the project is selected as a Finalist.
I am aware that if the project is selected as one of the six winning projects, the applicant (the person submitting this application) is the person who will receive the WISE Awards Trophy on behalf of the project at WISE 2015.

PLEASE SAVE THIS FILE IN WORD FORMAT

AND SUBMIT IT AT by January 15, 2015, 13.00 GMT

PART 1: THE PROJECT

GENERAL

Name of organization:

Project name (must be same as on page 1):[1]Limited to 60 characters

Year the project started:[2]

Project website address:

Nature and number of beneficiaries to date:

Reach of the project: click hereLocalNationalRegionalGlobal. Please indicate countries where the project operates (optional):

Has the project been replicated? If so, please specify location(s):

In one sentence, please state the main objective of your project:

GENERAL PRESENTATION OF THE PROJECT

Briefly summarize your project and provide information about its aim, impact, the context in which it operates and in what way it could be considered a model of excellence.

Limited to 1,000 characters

CONTEXT AND ISSUE

Please describe:1) the educational context in which your project is operating and state the educational challenge and/or social issue(s) that your project is addressing; 2) why, in your view, it is important to tackle these challenges and issues in the given context.

Limited to 1,000 characters

THE INNOVATION AND SOLUTION

Innovation can be of many kinds depending on the context. Please state: 1) in what way the project, or its components, are innovative in the given situation; 2) how the project distinguishes itself from other actors in similar fields;3) how the activity is innovative in the use of educational tools, design, methodology, media and/or practice.

Limited to 1,500 characters

IMPACT & ACHIEVEMENTS

Please explain:1) how the project has transformed an aspect of education and the effect this is having on beneficiaries and the community or society at large; 2) how the project ensures delivery of quality of learning as well as its relevance in the real world;3) the key impacts and how impact is assessed and progress is monitored.

Limited to 1,500 characters

SUSTAINABILITY & FUTURE DEVELOPMENTS

Please indicate:1) how the organization’s structure ensures the sustainable development of the project;2) how the project has been funded to date and how the project is seeking to ensure future funding; 3) the future objectives of the project in the months/years to come and how it plans to achieve these.

Limited to 1,000 characters

PART 2: THE ORGANIZATION LEADING THE PROJECT

1. DETAILS OF THE ORGANIZATION

Name of organization:

Legal registration/license number:

Size of organization:click here1-10 employees/members11-50 employees/members51-100 employees/members101-1000 employees/members1001 - or more employees/members

Education sector: click herepre-primary educationprimary educationsecondary educationtertiary educationvocational trainingfurther or higher educationspecial educational needs education for people with disabilitiesinformal learningdistance-based learninglife-long learningother (please specify in free text section) Other:

Type of organization:click hereSchool, or School ConsortiumUniversity, or Academic NetworkCivil Society OrganisationCommunity OrganisationGovernment OrganisationInternational AgencyPrivate Sector Companyother (please specify in free text section) Other:

Size of organization revenue: click here$ 0 – 10.000 $ 10.000 - 50.000$ 50.000 - 100.000$ 100.000 - 500.000$ 500.000 - 1 million$ 1 million - 5 million$ 5 million - 10 million$ 10 million - 50 millionOver $ 50 millionIf over $50 million please specify:

Region where the activity is taking place: click hereGlobalAsiaAustralasia/OceaniaEuropeMiddle East and North AfricaNorth AmericaSub-Saharan AfricaLatin America

Postal address line 1:

Postal address line 2:

Town/City:

Postcode:

Country of registration:

Organization website address:

Organization phone number:

If your organization is partnering with other entities/institutions to manage this particular project, please provide the name and address for each partner and the percentage of the work that they are performing:Limited to 1000 characters

Please provide details of any counterpart funding or input in kind by partner organizations:

Limited to 1000 characters

How and when do you envisage using the Award money of $20,000 (US) if your project is selected as one of the 2015 winning projects?

Limited to 700 characters

2. DETAILS OF THE PROJECT REPRESENTATIVE

Please note that the person submitting the application form is considered the applicant representing the project and the team working on the project. If your project is selected, the individual applying will be the recipient of the Award.

Title:

First name(s):

Family name/Surname:

Position within organization:

E-mail:

Phone number:

Short biography of applicant (250 words written in third person):

PART 3: REFERENCES

1. SUPPORT FROM TWO EXTERNAL REFEREES

Contact details and complete information on two external referees (e.g. former donors, local governments, other NGOs, etc.) must be included in all applications. The referees should have no family relation to the leadership of the applicant organization. Failure to include these contact details will automatically lead to the rejection of the application. WISE reserves the right to contact the referees at any stage during the evaluation process.

Referee 1:

Full name of referee:

Institutional title/role of person endorsing this application:

Organization:

Email address:

Phone number:

Relation to project representative: (in one sentence)

Referee 2:

Full name of referee:

Institutional title/role of person endorsing this application:

Organization:

Email address:

Phone number:

Relation to project representative: (in one sentence)

1

[1] If your project does not yet have an official name, please provide one for future use.

[2] If the project is limited in time, please provide a beginning and end date above and mention any challenges/threats that may affect the project.