APPLICATION FOR CSC AWARD 2014
1. ABOUT THE APPLICATION
Category:
Type:
Individual category
Organisation/institution category
Practitioner/activist
Theorist/ researcher
Type of Nomination:
What type of nomination is this?
Self-nomination
External nomination
2. APPLICANT DETAILS
Full Name: (as
on passport)1
Gender
Female
Organisation name (if
applicable):
Country:
Postal
Address:
Email:
Telephone: (include
area/ country codes)
Work:
Home:
Title:
Male
Position:
City:
Web address
Mobile:
Fax:
If this is an external nomination, please fill in these details:
Name:
Position:
Organisation:
Country:
City:
Address:
Email:
Telephone:
Web address
Work:
Mobile:
Home:
Fax:
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If this is an organisational application, please list a representative of the organisation (who would attend the
Awards Ceremony).
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3. REASONS FOR NOMINATION
Note: Please provide sufficient information for the CSC Award Jury to make an informed decision.
Please refer to the CSC Award objectives and eligibility criteria to structure your answer. These
questions can be completed by either the applicant or by the external nominator, and can be filled
out in a separate document if desired. Please limit the response to each question to 400 words.
a) How does the work of the nominee contribute to key communication for social change themes?2
b) What key achievements/activities qualify you the nominee for this award?
c) Why did the nominee’s as an individual/organisation pursue these activities?
d) How has the nominee’s work contributed to sustainable development?
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Key communication for social change themes may include ICTs and social change/development, participatory
development communication, community media, participatory communication tools, communication rights,
edutainment, behaviour change communication, media and empowerment, media education. Please note that
this award is not for traditional journalistic activities.
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e) What are the long term impacts of the nominee’s work? Please include evidence of impact at a
local, national or international level and feel free to include support materials that address this.
f) What obstacles have the nominee overcome to undertake the work they do?
4. Additional information:
Is there any relevant supporting documentation or additional information, which will provide
evidence of the information you have provided? Please attach website links, copies of newspaper
clippings, project documents, articles, etc.
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