UNITED NATIONS OFFICE ON SPORT FOR DEVELOPMENT AND PEACE Villa La Pelouse Palais des Nations CH- 1211 Geneva Telephone: +41 22 917 27 14 Fax: +41 22 917 07 12 E-mail: idsdp@unog.ch Website: www.un.org/sport 2015 International Day of Sport for Development and Peace Video Contest Basic Information Form All organizations interested in submitting a video clip are asked to kindly provide the information requested in the form below. Completion of this document is mandatory for an organization to be considered a participant of the 2015 International Day of Sport for Development and Peace Video Contest. Thank you. 1. Information about Organization/Project Name of Organization: Address: Date of Establishment: Contact Person (please provide, name, title, telephone number and e-mail address) Official Website: Social Media Platforms: (please provide links to your organization’s official pages in social media): What are the thematic areas addressed by your Organization? (Check all that apply) Fostering Development of Children and Youth Promoting Sport for Persons with Disabilities Gender Equality and Empowerment of Women and Girls Health Promotion and Disease Prevention Poverty Alleviation Others, please indicate: Peace Building/Conflict Resolution Social Inclusion Trauma Relief Environmental Education Economic Growth ________________________________________________________________________________________ Background (maximum 200 words) What are the vision and mission of your organization? Objectives of your Organization/Project (maximum 500 words) What are the social challenges and issues that your organization/project addresses? Who are the beneficiaries/ target groups of the project? What are the specific objectives of the project? Achievements of your Organization/Project (maximum 500 words) What are the main outputs of your project? What impact did your project create in the community? 2. International Day of Sport for Development and Peace (IDSDP) Does your organization plan to celebrate IDSDP this year? If so, please describe the activities. (maximum 200 words) 3. Video Submission Please insert here the direct download link to the video file submitted for the Contest (see further guidance on uploading in the Terms and Conditions on our website): Completed form must be submitted via e-mail to idsdp@unog.ch before 1 March 2015, 11:59 PM (EST)