Wireless Reach Proposals: 2012
Contact Information of Contact Filling Out Form
First Name of Contact Filling Out Form
Last Name of Contact Filling Out Form
Job Title of Contact Filling Out Form
Email Address of Contact Filling Out Form
Work Phone Numberof Contact Filling Out Form
Mobile Phone Number of Contact Filling Out Form
Street Address of Organization
City of Organization
State / Province of Organization
Zip Code of Organization
Country of Organization
Type: Education, Entrepreneurship, Environment, Health Care, or Public Safety
Wireless Reach 2012 Budget Request
Requested Funding (Amount in USD)
A)State precisely what Wireless Reach dollars will fund.
B)Who is the recipient of those dollars?
C)What will be the measurable outcomes/milestones by quarter?
D)What will be the measurable outcomes/milestones one year after the start of implementation?
A)Please include the goal, target beneficiaries, and the need that will be addressed through this project.
B)Describe how Qualcomm technology will be used in the project.
C)How will this project be sustainable? (For example, after the project has been funded, will the recipients of the grant be able to maintain and grow the services? Does the project have any built in revenue mechanism?)
Partners – Their Roles and Contributions
Describe the roles of partners and their incentive for making the project a success in the fields below and include a US Dollar amount for their contribution whether in-kind or cash. Also state whether the partner is confirmed or tentative.Partner Name / Partner Description / Service Provided / Cash or In-kind Contribution / Valued Amount in USD$ / Confirmed or Tentative
- Background information on your organization.
- How doesthe proposed project meetthe goals of your organization and promote country goals (ICT, education, health care, etc.)? Please state any relevant public government initiatives.
- How doesthe proposed projectdemonstrate that advanced wireless technologies can improve people’s lives in the areas of education, health care, entrepreneurship, public safety or the environment?
A)What is the plan to monitor and evaluate the progress of the project against the stated goals and objectives?
B)What organization will conduct the above stated monitoring and evaluation plans (your organization or another organization)?