managing water resources and thereby, improving the economic and social conditions ... For more details, please visit th
IDB PRIZE FOR WOMEN’S CONTRIBUTION TO DEVELOPMENT 10th EDITION
WOMEN’S CONTRIBUTION TO WATER RESOURCES MANAGEMENT
NOMINATION FORM
INDIVIDUALS The 10th Edition of IDB Prize for Women’s Contribution to Development aims to recognize the essential role of women in managing water resources and thereby, improving the economic and social conditions of their communities.
RECOGNIZING WOMEN’S INNOVATIVE SOLUTIONS FOR MANAGING WATER RESOURCES In recognition of the outstanding achievements made by women to develop and implement innovative solutions to enable the community to have access to safe and affordable water for domestic use and/or production, and hence improving the economic and social conditions of their communities
In order to be considered for the Prize, the attached form must be completed in its entirety and submitted with the required documents. For an electronic copy of the form please visit (www.isdb.org). If submitting electronically, complete the form and submit via email. Alternatively, you may print this form and neatly handwrite or type your response. See section 14 for a list of required supporting materials and section 15 for submission instructions.
TO APPLY The Nominee must :
•
Be a woman.
•
Engage in activities and /or reside in one of the IDB member countries or in a Muslim community in non-member countries.
•
Hold values and principles and exhibit work that do not conflict with those of the IDB.
•
Have activities that have proven to be effective.
•
Have developed or be actively involved in projects/activities that are innovative and helped to improve
access to safe and affordable water.
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Have work that is exemplary and worthy of emulation.
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Serve as a role model for other women.
•
Be nominated by an organization.
SELF NOMINATION, NOMINATIONS BY INDIVIDUALS OR IDB STAFF WILL NOT BE ACCEPTED
For more details, please visit the IDB website at www.isdb.org. The deadline for receiving nomination forms and all supporting materials is 30th November, 2014. Nomination forms received after the deadline date will not be accepted. Any questions may be e-mailed to
[email protected].
1. NOMINEE’S INFORMATION
Name:
Last
First
Other Names
Prefix
Date of Birth:
Address:
City:
Country/Territory:
Postal Code:
Telephone:
Mobile:
Fax:
E-mail:
2. DETAILS OF THE INSTITUTION RECOMMENDING THE ABOVE NOMINEE (Self Nominations are Not Accepted)
Name of Organization:
Contact Person:
Last
First
Job Title
Address:
City:
Country/Territory:
Postal Code:
Telephone:
Mobile:
Fax:
E-mail:
How did you hear about the IDB Prize for Women’s Contribution to Development? Internet
Ministry of Finance
E-mail
Web-site
Other
3. BRIEF BIOGRAPHY ON THE NOMINEE
Provide a brief biography of the nominee detailing their socio-economic background, education and professional experience.
4. AWARDS AND RECOGNITION RECEIVED BY THE NOMINEE
List any awards and recognition the nominee has received for their activities and efforts related to the topic of the Prize.
5. NOMINEE’S ACTIVITIES RELATED TO THE TOPIC OF THE PRIZE
Provide details on the specific activities implemented by the nominee in which she contributed to develop and implement innovative solutions to improve access to safe and affordable water for domestic use and/or production. In this section you should provide specific details on the type of activities implemented by the nominee, including challenges and obstacles overcome to realize objectives.
6. BENEFICIARIES
Quantify the number of persons who benefitted from the nominee’s activities. Include and specify direct and indirect beneficiaries.
7. FINANCIAL ASSISTANCE
List the sources of funding received by the nominee to implement their activities related to the topic of the Prize.
8. IMPACT OF NOMINEE’S ACTIVITIES
Provide detailed information on how the nominee’s activities related to the topic of the Prize have significantly helped to improve access to safe and affordable water for domestic use and/or production. Include details on the impact and potential impact of their activities and how they have helped to inspire others.
9. CREATIVITY OF NOMINEE’S ACTIVITIES
Provide details on what makes the nominee exceptional or unique. What is outstanding or innovative about the nominee’s activities related to the topic of the Prize?
10. OUTREACH
Describe how the nominee’s activities related to the topic of the Prize, provide services to a particular segment of a community and how these services are extended to the larger community and beyond.
11. SUSTAINABILITY
Provide details on how the nominee is able to maintain and continue her activities, financially and operationally. Provide details on how the nominee’s activities will help to support future generations. Describe any changes and benefits within the community which were stimulated or caused by the nominee.
12. APPLICATION OF AWARD
How will the award be used to further the activities of the nominee related to the topic of the Prize.
13. SUPPORTING MATERIALS
List all of the supporting documents submitted along with the application. If you would like to submit any supporting documents electronically, you may list them here.
14. REQUIRED SUPPORTING MATERIALS
In addition to the completed nomination form, the following supporting materials are required:
• Letter from nominating organization.
• Two letters of reference (each letter of reference must provide the name, address, position, telephone number and email address of the referee) who can confirm the accuracy of the information submitted on the nomination form and attest to the dedication and commitment of the individual nominated.
• Documents attesting to the achievements of the nominated individual (certificates of acknowledgment, photographs, videos, news articles, brochures, leaflets, personal stories from women benefitting from the work of the individual, reports from others on the achievements of the individual, etc.)
• Report of any additional organizations with which the nominee is affiliated, works, has membership, is on the board, etc.
15. SUBMISSION INSTRUCTIONS
• If possible, the nomination form, together with all supporting materials should be e-mailed to
[email protected].
• If the materials sent exceed the limit of sending by one email, please submit in clearly marked, separate e-mails.
CHECK LIST FOR COMPLETED APPLICATION FORM
Nomination form Letter of recommendation from nominating organization Two reference letters Supporting documentation on the individual and their activities related to the topic • Letters of reference and any other documents that cannot be sent electronically should be sent via standard mail to this address:
Capacity Development Department Islamic Development Bank P.O. Box 5925 Jeddah 21432 Saudi Arabia Tel: +966 12 6466787 / 6722 Fax: +966 12 6467828 Email:
[email protected]
The deadline for receiving nomination forms and all supporting materials is
30th November, 2014
Nomination forms received after the deadline date will not be accepted.