Application form for the Youth Democracy Award 2012 Please answer the following questions and send this form (in .doc or .pdf format) by post or e-mail to the address below. Please note that only complete and signed applications will be considered! Please be brief and fill in all the blanks including sub-items – if possible electronically! The evaluation of the projects is exclusively based on the information provided in the application form. Supplementary information is not taken into consideration and cannot be sent back! I. General information about the project and project administrator(s) Project name Project administrator Applicant’s role within the project Contact person and details Summarise your project in one sentence: Information on the project scope The project [ ] was implemented from till [ ] has been running since [ ] is planned from till till Locations/ Countries Number of persons involved (participants / organisers) Organisations involved/cooperation partners (including institutions): If the project has already taken place/has been finished: Are there plans for a follow-up project? II. Short description of the Project (goals, contents, effects) 2.1 Project depiction: Please describe your project in a short and compelling manner (200 words max). What topics did you bring up? In what way are young people actively involved in the project? What activities are planned? What is your project going to achieve? In what way is your project related to democracy or how does your project enhance democracy? 2.2 Who do you want to reach? (150 words max) Who and how many people will be reached by your project or have already been reached? Which target group is the project designed for? 2.3 What is your schedule and action plan? (150 words max) If your project is forthcoming, please describe your schedule and your current state of planning. If your project is currently going on or has already finished, describe shortly your course of action, what is/was planned etc. (e.g. preparatory meetings, project schedule, applications for funding)? 2.4 What societal changes shall your project bring about? (150 words max) Please briefly summarise what effect your project will have or has had on the participants. Can you observe any sustainable changes in the social environment? Is there a multiplier effect? 2.5 Which results will persist after the project will have ended? (100 words max) What are the long-term results of your project? (For example networks, (printed or online) publications, documentations, council orders, etc.)? 2.6. Why should your project of all projects be awarded? What would you do with the prize money? (100 words max) III. Project funding 3.1. Total budget of the project 3.2. How was/is your project financed? Please cross where applicable. Multiple answers possible. Financed by the project administrators themselves (percentage of the total budget:) Third-party funding (promoters and sponsors) If yes - please specify yes □ yes no □ □ no □ Other resources (number of full-time employees and volunteers, premises, technology, etc.) Has the project already been awarded? If yes, by whom? IV. Profile of the project administrators 4.1 Profile of the project administrators (75 words max) Type of organisation (e.g. independent, confessional, youth group, association, etc.); number of responsible people (full-time or volunteers, age) 4.2 Implementation of the project (75 words max) How do you organise your project? How participatory is it for the project group? In what ways can young people get involved in the implementation of the project? 4.3 Current activities (50 words max) Please introduce yourself briefly and describe your current activities. How did you find out about the Youth Democracy Award 2012? I hereby agree to the privacy policy and the use of the data by the Federal Agency for Civic Education (bpb) in case of a successful application. Signature / Date Please send your project description per E-Mail by 8 April, 2012 (date of receipt by bpb) to Svetlana Alenitskaya Bundeszentrale für politische Bildung/bpb Fachbereich Veranstaltungen Adenauerallee 86 D-53113 Bonn Tel. + 49 (0)228 99 515 509 Fax. + 49 (0)228 99 515 293 svetlana.alenitskaya@bpb.bund.de