COMMITMENT TO ACTION FORM COMMITMENTS TO ACTION 2012 – 2013 UNAOC Partners Forum – Commitment to Action Form Istanbul, Turkey, May 31 2012 Please fill in the Commitment Form and submit it to the UNAOC Secretariat in New York by email: farhadz@unops.org or fax: 212-457-4032. Thank you in advance. 1. INTRODUCTION Commitments can be all sizes – small or large; all levels – global or local; all kinds – financial or nonmonetary in nature. Commitments are first and foremost a plan for addressing a significant challenge – such as youth needs, education, migration or media – or contributing to find innovative solutions for making the world a better place in which to live through achieving the Alliance’s goals. Many commitments are the result of cross-sector partnerships, combining efforts by all players to scale up their projects and expand their impact The UNAOC supports the development of commitments to action by facilitating dialogue, providing opportunities to identify projects and commitment partners, showcasing the actions taken by members, and communicating results. Sometimes it also tries to open up new avenues for cooperation around concrete innovative initiatives that it leads. 2. COMMITMENT BY : (name, title, organization, country) 3. COMMITMENT TO ACTION INFORMATION Commitment Name: Commitment Area Education Media Migration Youth Cross-cutting - please list relevant focus areas : S Individual Commitment Group Commitment 4. GEOGRAPHICAL FOCUS: Please list region(s) the commitment targets: Africa North America Asia Mediterranean Region Europe Oceania Latin America & Caribbean South-East Europe Worldwide Countries/cities (please, specify): 2 5. COMMITMENT DURATION (please specify the time period in months/years it will take to complete your commitment to action) 6. BACKGROUND & SUMMARY 1. Summary (please use overview provided in the Pledge Form) 2. Objectives 2.1. Overall goals- 2.2. Anticipated impact 2.3. Total number of beneficiaries 3 3. Types of activities you will you will engage in to achieve the objectives of your commitment to action: 3.1. Awareness building 3.2. Capacity building 3.3. Policy dialogue 3.4. Advocacy 3.5. Others (specify) 4. Implementation Strategy 4.1 – launch date for your commitment 4.2- actions to be taken to implement your commitment (specify implementation period for each action and target group) 4.3. specify targets to be achieved and how to measure progress 4 7. PARTNERSHIPS OPPORTUNITIES 7.1 Partnership opportunities – describe resources/assistance/partnerships you are looking for or offering in relations to your commitment to action 7.2 Role of the UNAOC - How can the UNAOC assist you in achieving your Commitment to Action? 8. FUNDING 8.1.– estimated total costs for commitment over its duration 8.2.Expected/targeted sources of funding 8.3. First year expected costs : 8.4.Funds raised to date: 5 9. CONTACT DETAILS Name Title Agency / Institution / Country / Organization / Title: Department: Address: Telephone: Fax: Email: Website: 6