Please fill out the questionnaire separately for each activity you wish to submit.
* Denotes mandatory fields.
DETAILS OF THE ORGANIZATION
Name * :
Type * : /
Country * : /
Website (url) for this Entity :
DETAILS OF THE CONTACT PERSON (Personal contact information will not appear on the website. However, the designated contact may be contacted for more information)
Family Name * :
First Name * : /
Address :
Country * : /
Email * : / Let others contact me (without disclosing any of my contact information)
Telephone :
INFORMATION ABOUT THE PROJECT
ProjectTitle * : / Please provide a short title for this project, programme, thematic meeting, event, etc
Title acronym :
Description * : / Please provide a brief description of the project within 150-250 words, highlighting the project's contributions towards achieving the Sustainable Development Goals. In case your project gets nominated for the next phase, this information will be publically available for consideration by the participants in the Online Voting Phase
More Information : / Please provide a website for this activity
Website (URL):
Geographical Coverage* : / Please tick a box to indicate the geographical coverage
Local National Regional International
Please specify coverage :
Timescale * : / Please tick a box to indicate the timescale of the activity
Completed Planned for future Ongoing
Specify dates using the format day/month/year (dd/mm/yyyy) :
From: To:
Partners: / Please provide the names of other partners involved:
Category* : / Please, select the category (WSIS Action Lines) most relevant to this activity. Please, remember that you can tick just one.
1. The role of governments and all stakeholders in the promotion of ICTs for development
2. Information and communication infrastructure
3. Access to information and knowledge
4. Capacity building
5. Building confidence and security in use of ICTs
6. Enabling environment
7. ICT applications:E-government
8. ICT applications:E-business
9. ICT applications:E-learning
10. ICT applications:E-health
11. ICT applications:E-employment
12. ICT applications:E-environment
13. ICT applications:E-agriculture
14. ICT applications:E-science
15. Cultural diversity and identity, linguistic diversity and local content
16. Media
17. Ethical dimensions of the Information Society
18. International and regional cooperation
Internationally-agreed development goals outlined in the 2030 Agenda for Sustainable Development: / Is this project relevant to achieving the SDGs listed below? (seesustainabledevelopment.un.org)
Please tick all goals that apply*
1.End poverty in all its forms everywhere
2.End hunger, achieve food security and improved nutrition and promote sustainable agriculture
3.Ensure healthy lives and promote well-being for all
4.Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
5.Achieve gender equality and empower all women and girls
6.Ensure access to water and sanitation for all
7.Ensure access to affordable, reliable, sustainable and modern energy for all
8.Promote inclusive and sustainable economic growth, employment and decent work for all
9.Build resilient infrastructure, promote sustainable industrialization and foster innovation
10.Reduce inequality within and among countries
11.Make cities inclusive, safe, resilient and sustainable
12.Ensure sustainable consumption and production patterns
13.Take urgent action to combat climate change and its impacts
14.Conserve and sustainably use the oceans, seas and marine resources
15.Sustainably manage forests, combat desertification, halt and reverse land degradation, halt biodiversity loss
16.Promote just, peaceful and inclusive societies
17.Revitalize the global partnership for sustainable development
Project Type * : / Please tick one or more boxes to indicate the type of activity described above
Project Programme WSIS Thematic Meeting Conference Publication Training initiative Guidelines Tool-kit Website Database
Other (please specify) :
II. Part two. Project Information 1500-2000 words
In order to complete the submission, please complete part 2 and a photo to you project submission:
The project information document should clearly demonstratethe following:
- The relevance of the project to the respective WSIS Action Line as referenced in the Geneva Plan of Action.
- The results achieved and impact generated.
- Community empowerment.
- Relevance to Sustainable Development Goals.
- Ability of the model to be replicated.
- Sustainability of project.
- Partnerships development.
- Promotion of WSIS values in the communities.
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