Global Youth Award Nomination form

1. GLOBAL YOUTH AWARD 2016
Mail the completed form at worldyouthsummit2016@gmail.com .
www.wys2016.org
Please read the following instructions / guidelines:
 Please ensure that filled in text is not repeated in the responses against the items in Part I,
Part II and Part III.
 Please fill the form liberally and attach extra documents and links so that the expert panel
gets adequate information about your project in the best possible manner.
 Questions marked with asterisk * are mandatory. However, we recommend filling all fields.
 Please provide additional information, documents etc. in support of your idea /project/
application/ solution /innovation.
 Nominated project must be implemented on the ground for at least 1 year.
 Please provide 3 testimonials in support of your idea /project/ application/ solution
/innovation.
 It is mandatory to provide an audio-video of 3-5 minutes about your nominated work.
 It is mandatory to provide at least a list of beneficiaries with contact details about the
applicant’s nominated work (25 beneficiaries at least with mix of gender, caste,
community diversity).
Part I - Overview
1. Nomination category
 Advocacy & Empowerment
NOMINATION FORM

2.  Education
 Environment
 Health
 Livelihood, Skill Development,
Entrepreneurship & Employability
 Technology for Development
 Women Empowerment
 Youth Development & Empowerment
 Culture & Heritage
 Social, Gender & Financial Inclusion
2. Name of the project(in English):
3. Name of the project in original language:
4. Project launch since
5. Project location (Community, village,
panchayat, block, district)
6. URL (If Online):
7. Project summary (50 words)
8. Short description of the project: (100
Words)
Part II - Implementation Details
9. The background idea / reason / necessity to
implement the project (Max. 100 words)
10.Implementation Methodology (Max.100
words)
11. Community participation & engagement in
implementing the project? (Max. 100
words)
Part III - Project Details
12.Chronology*
a. Current Status of the project
b. Launch Date of the project
c. Completion Date of the project

3. d. Other Important dates & events during the
journey of the project:
13.What has the project delivered / solution
provided to the beneficiaries? (Complete list
of deliverables to the end user /target group
through this initiative) (Max.100 words)
14.Describe the sustainable model (Not more
than 100 words)
15.Quantitative & qualitative impact of the
project in diverse locations and people.
Max. 100 words)
16.Partners, collaborators, agencies involved
in developing, implementing and running
the project? (Max. 100 words)
17.Provide some user experience on how your
project has impacted their life? (Max. 100
words)
18.How is your project unique? (Describe the
Uniqueness of your Innovation in terms of
Originality of Idea / Method/ Development
Model/ Technology / Application /
Implementation that your product/project has
which makes it different). (Max. 200 words).
19.How cost effective and affordable to deploy
and run the project if it is implemented /
replicated in other location? (Max. 100
words)
20.Can the project be easily scalable and can
be expanded?
21.What is your vision of “Youths for
Sustainable Development” ?(100 words)
Part IV - Producer (Individual/Organization) information
22.Name of Applicant Organization
(Nominees)*
23.Contact Person*
24.Street Address*
25.City*

4. 26.Post Code*
27.State*
28.Country*
29.Mobile, Telephone, Fax*
30.Email(s)*
31.URL/Website
Heads, Team Members, Partners, Clients, who have significantly contributed*
S.No. Name Organization Designation Email Phone Role
Note:
1) Applicant may add any additional testimonials, press coverage, certificates etc.
that will help the jury panel to judge the projects effectively and qualitatively.
2) Last date of application received will be September 30, 2016.
3) Nominal Registration Fees will be apply for Nominated individuals /
Organizations.