‫ﺑرﻧﺎﻣﺞ دﻋم اﻟﻣﺟﺗﻣﻊ ﻓﻲ ﻟﺑﻧﺎن‬

Monitoring and Evaluation Unit ‫ﻗﺴم اﻟﻤﺘﺎﺒﻌﺔ واﻟﺘﻘﯿﯿم‬

Task Order: TO2 �x - TO3 � - TO4 � ‫ﻣﻌﻠﻮﻣﺎت ﺧﺎﺻﺔ ﺑﺎﻟﻤﺸﺮوع‬

Component: 1 � Community Stabilization
Fiscal Year: Year 1 � - Year 2 � - Year 3 � - Year 4 �
2 �x Community Development
Year 5 �x
3 Other; _____________________
Geographic Location:
Akkar � - Baalbeck-Hermel � - Nabatieh � Reporting Period: Oct/Dec � - Jan/Mar � Apr/Jun � - Jul/Sep �x
Beqaa �x North Lebanon � South Lebanon �

District: ___West Beqaa__________________________________ Village: ___Es Soutan Yaaqoub_______________

Activity Code: __BQA023__________

Indicator 1- Number of people benefitting from USG assistance.

Indicator 3- Proportion of female participants in USG assisted programs.
Indicator 21- Number of people directly benefiting from increased economic opportunities as a result of USG assistance in local communities
(Construction)

‫ﻋﺪد أﯾﺎم اﻟﻌﻤﻞ‬

# of ‫ﻣﻜﺎن اﻹﻗﺎﻣﺔ‬ ‫ﺗﺎرﯾﺦ‬
‫اﻟﻮظﯿﻔﺔ اﻟﺘﻲ‬ ‫اﺳﻢ اﻟﻤﺆﺳﺴﺔ اﻟﺘﻲ ﺗﻌﻤﻞ‬ ‫اﺳﻢ ﺻﺎﺣﺐ اﻟﻮظﯿﻔﺔ )اﻻﺳﻢ‬
working ‫اﻟﺠﻨﺴﯿﺔ‬ ‫رﻗﻢ اﻟﮭﺎﺗﻒ‬ ‫اﻟﻤﯿﻼد‬
‫اﻻﻣﻀﺎء‬ ‫ﺗﺸﻐﻠﮭﺎ‬ Residence
Date of
‫اﻟﺠﻨﺲ‬ Company ‫ﻟﺪﯾﮭﺎ‬ (‫اﻟﺜﻼﺛﻲ ﺣﺴﺐ اﻟﮭﻮﯾﺔ‬
days Nationality :Mobile #
Job title: address Name : Job Holder Name
Birth

15 ‫ﻋﺎﻣل دھﺎن‬ 71-802176 -11-3 � ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫ﻋﻠﻲ ﺣﺳن اﻟﺷﻠﺔ‬
� ‫ة‬/‫ﻟﺒﻨﺎﻧﻲ‬
‫ﻟﻮﺳﻲ‬ ‫أﻧﺜﻰ‬
X /‫ﺳﻮري‬ 1990
�

10 ‫ﻋﺎﻣل ﻧظﺎﻓﺔ‬ ‫اﻟﻤﺮج‬ � ‫ة‬/‫ﻟﺒﻨﺎﻧﻲ‬ 76061533 -7-21 � ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫ﻣﺣﻣد اﺣﻣد اﻟداﯾﺔ‬
X /‫ﺳﻮري‬ ‫أﻧﺜﻰ‬
1987
�
 ‫ﺑرﻧﺎﻣﺞ دﻋم اﻟﻣﺟﺗﻣﻊ ﻓﻲ ﻟﺑﻧﺎن‬

‫ﻋﺪد أﯾﺎم اﻟﻌﻤﻞ‬ ‫ﻣﻜﺎن اﻹﻗﺎﻣﺔ‬ ‫ﺗﺎرﯾﺦ‬

‫‪# of‬‬ ‫اﻟﻮظﯿﻔﺔ اﻟﺘﻲ‬ ‫اﺳﻢ اﻟﻤﺆﺳﺴﺔ اﻟﺘﻲ ﺗﻌﻤﻞ‬ ‫اﺳﻢ ﺻﺎﺣﺐ اﻟﻮظﯿﻔﺔ )اﻻﺳﻢ‬
‫اﻟﺠﻨﺴﯿﺔ‬ ‫رﻗﻢ اﻟﮭﺎﺗﻒ‬ ‫اﻟﻤﯿﻼد‬
‫اﻻﻣﻀﺎء‬ ‫‪working‬‬ ‫ﺗﺸﻐﻠﮭﺎ‬ ‫‪Residence‬‬
‫‪Nationality‬‬ ‫‪:Mobile #‬‬ ‫‪Date of‬‬
‫اﻟﺠﻨﺲ‬ ‫ﻟﺪﯾﮭﺎ ‪Company‬‬ ‫اﻟﺜﻼﺛﻲ ﺣﺴﺐ اﻟﮭﻮﯾﺔ(‬
‫‪days‬‬ ‫‪Job title:‬‬ ‫‪address‬‬ ‫‪Name‬‬ ‫‪: Job Holder Name‬‬
‫‪Birth‬‬

‫‪2‬‬ ‫ﺗﻧظﯾف اﻻﻟواح‬ ‫ﻟﺒﻨﺎﻧﻲ‪/‬ة‬ ‫‪79173992‬‬ ‫‪-8-4‬‬ ‫�‬ ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫ﻣﺣﻣد ﺧﺎﻟد ﻣراد‬
‫ﺳﻠﻄﺎن ﯾﻌﻘﻮب‬ ‫‪�X‬‬ ‫أﻧﺜﻰ‬
‫‪1990‬‬
‫ﺳﻮري‪/‬‬ ‫�‬

‫‪5‬‬ ‫ﻋﺎﻣل دھﺎن‬ ‫ﺷﺘﻮرة‬ ‫�‬ ‫ﻟﺒﻨﺎﻧﻲ‪/‬ة‬ ‫‪76063718‬‬ ‫‪-5-14‬‬ ‫�‬ ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫ﻓﺎدي اﺣﻣد اﻟﺳﯾد‬
‫‪X‬‬ ‫ﺳﻮري‪/‬‬ ‫أﻧﺜﻰ‬
‫‪1988‬‬
‫�‬

‫‪6‬‬ ‫ﻋﺎﻣل ﺻﺣﯾﺔ‬ ‫ﻛﺎﻣﺪ اﻟﻠﻮز‬ ‫ﻟﺒﻨﺎﻧﻲ‪/‬ة �‬ ‫‪76719562‬‬ ‫‪-7-29‬‬ ‫�‬ ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫ﺧﺎﻟد اﺑراھﯾم اﻟﺳﺑﻌﻠﻲ‬
‫ﺳﻮري‪X � /‬‬ ‫أﻧﺜﻰ‬
‫‪1989‬‬
‫�‬

‫‪12‬‬ ‫ﻋﺎﻣل ﺑﻧﺎء‬ ‫ﻟﻮﺳﻲ‬ ‫ﻟﺒﻨﺎﻧﻲ‪/‬ة �‬ ‫‪76113267‬‬ ‫‪-1-24‬‬ ‫�‬ ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫ﺻﺎﻟﺢ ﻣﺣﻣد ﺧﺷوف‬
‫ﺳﻮري‪� X /‬‬ ‫أﻧﺜﻰ‬
‫‪1991‬‬
‫�‬

‫‪7‬‬ ‫ﻋﺎﻣل دھﺎن‬ ‫اﻟﻤﺮج‬ ‫ﻟﺒﻨﺎﻧﻲ‪/‬ة �‬ ‫‪71529713‬‬ ‫‪-3-29‬‬ ‫�‬ ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫اﺣﻣد ﻏﺎزي ﺣﺳﯾن‬
‫ﺳﻮري‪� X /‬‬ ‫أﻧﺜﻰ‬
‫‪1992‬‬
‫�‬

‫‪2‬‬ ‫ﻋﺎﻣل ﺗﻧظﯾف‬ ‫ﺳﻠﻄﺎن ﯾﻌﻘﻮب‬ ‫ﻟﺒﻨﺎﻧﻲ‪/‬ة �‬ ‫‪76275301‬‬ ‫‪-6-3‬‬ ‫�‬ ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫وﺳﯾم ﻣﺻطﻔﻰ اﻟﻣﺣﻣود‬
‫اﻟﻔﻮﻗﺎ‬ ‫ﺳﻮري‪� X /‬‬ ‫أﻧﺜﻰ‬
‫‪1989‬‬
‫�‬

‫‪5‬‬ ‫ﻋﺎﻣل ﺑﻼط‬ ‫ﻟﻮﺳﻲ‬ ‫ﻟﺒﻨﺎﻧﻲ‪/‬ة �‬ ‫‪78862898‬‬ ‫‪-9-7‬‬ ‫�‬ ‫ذﻛﺮ‬ ‫اﻟﻔﺎ ﺑﺎور‬ ‫ﻣﺎھر ﻣﺣﻣد اﻻﺣﻣد‬
‫ﺳﻮري‪� X /‬‬ ‫أﻧﺜﻰ‬
‫‪1987‬‬
‫�‬

‫أﻧﺎ اﻟﻤﻮﻗﻊ‪/‬ة أدﻧﺎه‪ ،‬اﻟﺴﯿﺪ ‪ -----------------------------------------------‬رﺋﯿﺲ ‪ ----------------------------------------------------------------‬أؤﻛﺪ ﺻﺤﺔ اﻷرﻗﺎم اﻟﻮاردة ﻓﻲ اﻟﺠﺪول أﻋﻼه‪.‬‬

‫اﻟﺗوﻗﯾﻊ‪ --------------------------------------------------------------- ،‬اﻟﺗﺎرﯾﺦ‪---------------------------------------------------------- ،‬‬

‫ﺑرﻧﺎﻣﺞ دﻋم اﻟﻣﺟﺗﻣﻊ ﻓﻲ ﻟﺑﻧﺎن‬