Application Form 2017-06-12T05:55:25+00:00

Application Form

  • I        Background Information:

  • 1. Person who will be participating in the program.*

    If your organization focuses solely on the topic of fuel poverty, the applicant should be the founder, co-founder, director, or senior manager of the organization. If your organization has a broader scope, the applicant should be the project manager for or leader of the project relevant to the topic of fuel poverty.
  • II        Your Project:

  • If your organization focuses solely on the topic of fuel poverty, please interpret the word “project” as a synonym of “organization.” If, however, your organization has a broader scope, please answer the questions with information relevant to the project on fuel poverty.
  • This description will be used for our internal and external communication, so please be as specific and clear as possible and include the main activities of your project/organization.
  • Please include a breakdown of income, e.g. 50% from sales of product/services, 20% from public funds (government departments, local authorities), 10% from private companies, 10% from international institutions/organizations, 5% from corporate foundations, and 5% from private donations/subscriptions.
  • Accepted file types: pdf, xlsx, xls.
  • III        Your Social Mission and Impact:

  • Please include key statistics to measure the social issue(s) you are describing.
  • Please identify and quantify your direct and indirect target audience.
  • Please include both qualitative and quantitative indicators.
  • Please include both qualitative and quantitative indicators.
  • IV        Development Strategy:

  • V        You and the Social Innovation to Tackle Fuel Poverty Program:

    If you are selected, this agreement will be formalized in a written convention.
  • Relevant information may include a video of you pitching your project, infographics to describe your solution, etc.
  • Click on download and complete the Commitment from the Organization form and upload it below:

    Download
  • Please upload the Commitment from the Organization form completed and signed.
    Accepted file types: jpg, png, pdf, docx, doc.
  • This field is for validation purposes and should be left unchanged.

Do you need help with your application? Contact your Country Mobilizer.