Social Action Project Registration

1. Organization/ University Name:

2. Your Name:

3. Address: 4. Phone Number: 5. Email:

6. Name of the Implementing Youth group:

7. Name of team members and their roles:

Sr. Name Role in project

1
2
3
4
5
6
7

8. Title of the project:

9. Theme of your project. (Please tick your theme or specify in blank space)

1 Education 2 Health 3 Environment

4 Women Empowerment 5 Poverty 6 Gender Equality
7 Peace & harmony 8 Other (specify)

10. Location/Area of the project:

11. Duration of project: Start: End:

12. Target audience (specify age groups, geographic spread, and total estimated numbers):

13. Local available resources (e.g. people, government/private support, financial supports,
etc.):
 Background:

14. How will this Need:

project benefit i. How have the needs been assessed?
your community?

ii. Are there existing interventions addressing these needs?

What are the gaps?

iii. How is the proposed project introducing an innovative

approach to address the needs?

Objectives:

Feasibility:

15. How you will

start and manage
your social action Methodology/Approach:
project? i. Inclusion of local community members

ii. Implementation schedule/plan

iii. Individual roles of group members

 iv. Risks & Assumptions

Outcomes:

16. How you will

measure the Measuring Tools:
success of your
SAP?

17. How do you Strategy for handing-over to community:

envision your SAP
to be sustained in
the future?