Conservation & Environmental Grantshome.iprimus.com.au/tomandal/media/Application Form.pdfIf you are...

11
Conservation & Environmental Grants ........................................................................

Transcript of Conservation & Environmental Grantshome.iprimus.com.au/tomandal/media/Application Form.pdfIf you are...

Conservation & Environmental Grants

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If you are involved in a project to protect natural environment, or to

preserve cultural heritage, we want to hear about it.

The Ford Motor Company Conservation & Environmental Grants

is one of the world’s largest environmental and conservation grant

schemes, offering a total prize money of US$ 1,000,000 in over 50

participating countries.

The Grants program follows from the Henry Ford Conservation Awards,

originated in Britain in 1983 with a vision to encourage a wide range of

people to initiate or join schemes that help their local environment,

heritage and natural resources.

Since its introduction, more than 15,000 groups and individuals, across 34

European countries, have participated in Ford’s program. In 1997, a sister

initiative was launched in Brazil and because of its success, in 2000 Ford

has expanded the program worldwide.

Regardless of whether you are an individual working in your community

group or a member of a large organization, the Grants program is open

to everyone. It provides support to organizations and individuals that

focus on preservation of the natural environment and support

conservation in a noteworthy manner.

Individuals, environmental organizations and community groups are

invited to enter on-going projects in four categories: Natural Environment,

Heritage, Conservation Engineering, Child and Youth Projects.

Conservation & Environmental Grants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If extra items are to be returned, proper packing for return must be included.

ONLY ENTRIES CONFORMING TO THE ABOVE RULES AND REQUIREMENTS WILL BE ACCEPTED.

This program is open to all types of conservation initiatives (individual or group) that have alreadybeen implemented and ongoing. Projects that are still in the planning stages will not be considered.

Projects may be entered in any of the following categories :

Natural EnvironmentProjects to conserve flora, fauna and/or their respective habitats.

HeritageProjects to conserve man-made aspects of national or Asian heritage.

Conservation EngineeringProjects to reduce the rate of consumption of natural resources and/or pollution.

Child and Youth ProjectsAny conservation project involving young people aged 18 or under.

The Jury panel will select winners from any of the four categoriesin accordance with the following judging criteria:

1 Usefulness and Practicality2 Dedication3 Financial need4 Originality5 Replicability

Applicants are encouraged to log ontowww.ecoford.com for more details. Points 1 – 20 have to be answered completely.

A minimum of 4 different colour slides/photos of the Grantsprogram must be included with each entry. These will be retainedby the organisers and may be used for publicity about theprogram. They must be clearly marked with the project name,country and a description of the subject, and must be free of copyright. Winning projects must also be prepared to participate inselected and appropriate publicity efforts.

All above elements and any supporting material must be sent atthe same time.

The quality of your visual material is important and will form partof the judging procedure.

Where an entry is made in the Child and Youth Projects category,adult participation is acceptable providing it is restricted toadministrative support.

The judges’ decision is final.

Extra photographs, maps, documentary material, samples and soon may be included, but at your own risk, so please only sendmaterial of which you have copies , not original or unique materialof high value, or heavy or bulky items.

Rules and Regulations

Conservation & Environmental Grants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Conservation & Environmental Grants

Fill in the attached form and send it together with your complete application material to your local Program coordinator

Ford

Mo

tor

Co

mp

any

Co

nse

rvat

ion

& E

nvi

ron

men

tal

Gra

nts

Ap

pli

cati

on

Fo

rm

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Details about you (please write clearly in CAPITAL LETTERS)

1 Contact/Organiser name:

Contact/Organiser address:

Contact/Organiser telephone (incl. country and area code):

Contact/Organiser fax (incl. country and area code):

2 Are you entering as: an individual a group?

3 The name and type of your group or conservation initiative (i.e. school class, community group):

Details about your project

4 Country:

5 Category: Natural Environment Heritage Conservation Engineering Child and Youth Projects

6 Project name:

7 Please give a short and concise description of your project in English:

8 Project location: Country: Region: Nearest town:

9 When was your project started: Date Month Year

10 What encouraged you to start your project?

11 Please detail the outstanding characteristics of your project:

12 Does your project have an Asian/international significance? If so, please describe:

13 What is the long-term aim of your project?

14 Do you have a sponsor? No Yes If so, who

15 How much money has been spent on the project so far and where did this money come from:

16 Have you ever received Ford Motor Company funding? No Yes If so, when

17 How much more money is needed to complete the project?

18 In which part of your project will you invest your Grants money if you win?

19 Short description of your accompanying visual material (slide/photo):

20 Please provide a comprehensive description of the project including all objectives (300 words only).

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Isi borang yang dilampirkan dan hantarkan bersama bahan permohonan anda yang lengkap kepada Penyelaras Geran di tempat anda (alamatnya disenaraikarn di belakang folder permohonan).

Conservation & Environmental Grants

Ford

Mo

tor C

om

pan

y Co

nservatio

n &

Enviro

nm

ental G

rants

BO

RA

NG

PER

MO

HO

NA

N

Butir-butir mengenai diri anda (Sila tulis dengan jelas dalam Bahasa Inggeris menggunakan huruf besar)

1 Nama penyelenggara:

Alamat penyelenggara:

No. telefon penyelenggara (termasuk kod kawasan dan negara):

No. faks penyelenggara (termasuk kod kawasan dan negara):

2 Adakah anda memohon sebagai: individu? kumpulan?

3 Nama dan jenis kumpulan anda atau inisiatif anda (contohnya sekolah, kelas, kumpulan masyarakat, Pengakap atau Pandu Puteri dan sebagainya)

Butir-butir mengenai projek anda

4 Negara:

5 Kategori: Alam Sekitar Warisan Kejuruteraan Pemuliharaan Projek Kanak Kanak dan Belia

6 Nama projek:

7 Sila beri keterangan pendek dan ringkas mengenai projek anda dalam Bahasa Inggeris:

8 Lokasi projek: Negara: Rantau: Bandar terdekat:

9 Bilakah projek anda dimulakan? Tarikh: Bulan: Tahun:

10 Apakah yang mendorong anda memulakan projek anda?

11 Sila jelaskan tentang ciri-ciri luar biasa projek anda:

12 Adakah projek anda mempunyai kepentingan negara / antarabangsa? Jika ada, sila jelaskan:

13 Apakah matlamat jangka panjang projek anda?

14 Adakah anda mendapat penaja? Ya Tidak Jika anda mendapat penaja, siapakah penaja anda?

15 Berapakah wang yang telah dibelanjakan untuk projek anda setakat ini dan dari mana wang itu diperolehi: RM

16 Pernahkah anda menerima pembiayaan daripada Ford Motor Company? Tidak Ya Jika ya, bila:

17 Berapakah wang yang diperlukan untuk menyiapkan projek anda: RM

18 Jika berjaya, sila nyatakan di bahagian mana dalam projek anda wang Geran ini akan dilaburkan.

19 Sila beri keterangan ringkas mengenai bahan visual yang disertakan bersama permohonan ini (slaid/gambar).

20 Sila berikan teks keterangan lebih panjang mengenai projek, termasuk objektif-objektif anda (300 perkataan).

Conservation & Environmental Grants

°√ÿ≥“°√Õ°√“¬≈–‡Õ’¬¥„Àâ§√∫∂â«π·≈– àß„∫ ¡—§√¡“æ√âÕ¡°—∫‡Õ° “√·≈–Õÿª°√≥åÕâ“ßÕ‘ß ¡“µ“¡∑’ËÕ¬Ÿà∑’Ë√–∫ÿ¥â“π∑⓬‡≈à¡

°√ÿ≥“°√Õ°√“¬≈–‡Õ’¬¥‡°’ˬ«°—∫µ—«∑à“π (¥â«¬µ—«∫√√®ßÀ√◊Õ„™âæ‘¡æ奒¥)

‚§√ß

°“√√

à«¡„®

æ—≤π“ 

‘Ëß·«¥

≈âÕ¡·≈

– —ߧ

¡‰∑

¬

„∫ ¡

—§√

1 ™◊ËÕºŸâ ¡—§√ ∑’ËÕ¬Ÿà: ‡∫Õ√å‚∑√»—æ∑å∑’˵‘¥µàÕ‰¥â –¥«°: ‚∑√ “√ (°√ÿ≥“√–∫ÿ√À— ∑“߉°≈): 2 ∑à“π¡’§«“¡ª√– ß§å∑’Ë®– ¡—§√„ππ“¡¢Õß: ∫ÿ§§≈ °≈ÿà¡ 3 °√ÿ≥“√–∫ÿ™◊ËÕ ·≈–ª√–‡¿∑¢Õß°≈ÿà¡¢Õß∑à“π / ºŸâ√‘‡√‘Ë¡‚§√ß°“√: √“¬≈–‡Õ’¬¥¢Õß‚§√ß°“√∑’Ë∑à“πµâÕß°“√‡ πÕ¢Õ™‘ß∑ÿπ 4 ª√–‡∑»: 5 À—«¢âÕ‚§√ß°“√¢Õß∑à“π:  ‘Ëß·«¥≈âÕ¡ «—≤π∏√√¡ æ≈—ßß“π·≈–°“√Õπÿ√—°…å ‚§√ß°“√‡æ◊ËÕ‡¥Á° 6 ™◊ËÕ‚§√ß°“√: 7 °√ÿ≥“ √ÿª‚§√ß°“√¢Õß∑à“π‚¥¬¬àÕ·≈–‰¥â„®§«“¡: 8  ∂“π∑’˵—Èß‚§√ß°“√: ®—ßÀ«—¥ ‡¢µæ◊Èπ∑’Ë ‡¢µ„°≈⇧’¬ß: 9 ‚§√ß°“√π’ȇ√‘Ë¡¢÷Èπµ—Èß·µà: «—π∑’Ë ‡¥◊Õπ æ.». 10  ‘Ëß„¥§◊Õ·√ß®Ÿß„®„Àâ∑à“π‡√‘Ë¡®—¥µ—Èß‚§√ß°“√π’È¢÷Èπ 11 ‚§√ß°“√¢Õß∑à“π¡’≈—°…≥–‡¥àπÕ¬à“߉√: 12 ‚§√ß°“√¢Õß∑à“π¡’§«“¡ ”§—≠Õ¬à“߉√µàÕ¿Ÿ¡‘¿“§Õ“‡ ’́¬π ·≈–√–¥—∫π“π“™“µ‘ 13  ‘Ëß„¥§◊Õ®ÿ¥¡ÿàßÀ¡“¬ ”À√—∫‚§√ß°“√¢Õß∑à“π„πÕ𓧵 14 ∑à“π¡’ºŸâ π—∫ πÿπÀ√◊Õ‰¡à ‰¡à¡’ ¡’ ∂â“¡’‰¥â√—∫®“° 15 §à“„™â®à“¬∑—ÈßÀ¡¥„π°“√æ—≤𓂧√ß°“√π’È√«¡‡ªìπ‡ß‘π‡∑à“‰√ ·≈–¡’·À≈à߇ߑπ∑ÿπ®“°∑’Ë„¥ 16 ∑à“π‡§¬‰¥â√—∫∑ÿπ π—∫ πÿπ®“°øÕ√å¥ ¡Õ‡µÕ√å §Õ¡ª“π’ À√◊Õ‰¡à ‰¡à‡§¬ ‡§¬ ‡¡◊ËÕ‰À√à 17 ‡æ◊ËÕ„À₧√ß°“√π’È∫√√≈ÿ∂÷߇ªÑ“À¡“¬∑’Ë∑à“πµ—È߉«â ∑à“πµâÕß°“√‡ß‘π∑ÿπ π—∫ πÿπ‚§√ß°“√π’ȇæ‘Ë¡Õ’°‡∑à“‰À√à ∫“∑ 18 „π°√≥’∑’Ë∑à“π‰¥â√—∫§—¥‡≈◊Õ° ∑à“π®–π”‡ß‘π∑ÿπ π—∫ πÿππ’ȉª„™â„π à«π„¥¢Õß‚§√ß°“√ 19 °√ÿ≥“√–∫ÿ√“¬≈–‡Õ’¬¥¢Õß ‘Ëß∑’Ë·π∫¡“ ‡™àπ √Ÿª∂à“¬  ‰≈¥å ·ºπ∑’Ë À√◊Õ‡Õ° “√·π∫µà“ßÊ : 20 °√ÿ≥“‡¢’¬π∫∑ √ÿª¢Õß‚§√ß°“√ æ√âÕ¡∑—Èß √ÿª√“¬°“√¢Õß ‘Ëß∑’Ë∑à“π·π∫¡“æ√âÕ¡°—∫„∫ ¡—§√ (µ—«∫√√®ß‰¡à‡°‘π 300 §”)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Ford

Mo

tor C

om

pan

y Co

nservatio

n &

Enviro

nm

ental G

rants

Isi formulir terlampir dan kirimkan bersama dengan materi aplikasi lengkap kepada Program koordinator lokal anda.

Conservation & Environmental Grants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Biodata lengkap (harap diisi dengan HURUF BESAR)

1 Nama penyelenggara:

Alamat penyelenggara:

No. Telp penyelenggara (termasuk kode negara dan kota):

No. Fax penyelenggara (termasuk kode negara dan kota):

2 Apakah anda mengikuti program ini: secara individual secara kelompok

3 Nama dan jenis kelompok atau kelompok konservasi anda (contoh: persatuan/kelompok di sekolah, kelompok komunitas):

Data lengkap mengenai proyek anda

4 Negara:

5 Kategori: Lingkungan nasional Peninggalan/warisan Teknik konservasi Proyek anak dan remaja

6 Nama proyek:

7 Deskripsi singkat dan lengkap mengenai proyek anda dalam bahasa Inggris:

8 Lokasi proyek: Negara: Propinsi: Kota terdekat:

9 Proyek anda dimulai pada: Tanggal: Bulan: Tahun:

10 Apakah yang memotivasi anda untuk melakukan proyek anda?

11 Jelaskan mengenai karakteristik yang menonjol pada proyek anda:

12 Apakah proyek anda mempunyai kepentingan yang berhubungan dengan Asia atau Internasional? Jika ya, harap dijelaskan:

13 Apakah tujuan jangka panjang dari proyek anda?

14 Apakah anda mempunyai sponsor? Tidak Ya Jika ya, sebutkan:

15 Berapa jumlah dana yang telah anda keluarkan sejauh ini dan dari manakah dana itu berasal?

16 Apakah anda pernah menerima bantuan dana dari Ford Motor Company? Tidak Ya Jika ya, sebutkan:

17 Berapa sisa jumlah dana yang anda perlukan untuk menyelasaikan proyek anda?

18 Pada bagian manakah dari proyek anda akan menginvestasikan dana hadiah dari program ini jika anda menang?

19 Deskripsi singkat tentang materi visual pendukung anda (slides/foto):

20 Harap jelaskan mengenai proyek anda termasuk semua tujuan dengan HURUF BESAR (hanya 300 kata):

Ford

Mo

tor C

om

pan

y Co

nservatio

n &

Enviro

nm

ental G

rants

FOR

MU

LIR P

END

AFTA

RA

N

Completed entry forms are to be sent to the following address:

CAMBODIAFord Motor Company Conservation &Environmental GrantsAttn: Michael FreemanR.M. Asia FordNo. 27 Street 134P.O. Box 55Phnom PenhCambodia

Tel: (85-5) 23 366 151 (85-5) 23 307 654

MALAYSIAFord Motor Company Conservation & Environmental Grantsc/o Ogilvy Public Relations WorldwideLevel 11, Menara Milenium8 Jalan Damanlela, Bukit Damansara50490, Kuala LumpurMalaysia

Tel: (60-3) 2718 8253

PHILIPPINESFord Motor Company Conservation &Environmental GrantsOffice of the PresidentFord Group Philippines, Inc.FGP Bldg., American RoadGreenfield Automotive ParkSanta Rosa, Laguna 4026Philippines

Tel: (63-49) 541 5187 / 5173

INDONESIAFord Motor Company Conservation &Environmental GrantsAttn: Nova Willem / Andriani SudjanadiOgilvy Public Relations WorldwidePlaza Bapindo, 25th Floor Bank Mandiri TowerJakarta 12190Indonesia

Tel: (62-21) 526 6261 ext. 1422/1406

THAILANDFord Motor Company Conservation &Environmental GrantsOgilvy Public Relations Worldwide11th Floor, Silom Center2 Silom Road, Bangkok 10500Thailand

Tel: (66-2) 632 8300 - 7

VIETNAMFord Motor Company Conservation &Environmental GrantsThien Ngan (Galaxy) Co., Ltd.Suite 305 - North Star Building4 Da Tuong Street, HanoiVietnam

Tel: (84-4) 9420 383 / 84 / 85

Ford Motor Company Conservation &Environmental GrantsThien Ngan (Galaxy) Co. Ltd.9/2 Ton Duc Thang streetDistrict 1, Ho Chi Minh CityVietnam

Tel: (84-8) 9102 007 / 08

www.ecoford.com

PRIN

TEDON RECYCLED

PAPE

R

Conservation & Environmental Grants

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .