Conservation & Environmental Grantshome.iprimus.com.au/tomandal/media/Application Form.pdfIf you are...
-
Upload
phungquynh -
Category
Documents
-
view
217 -
download
0
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√– ߧå∑’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 §”)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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