Inclusion By Design
IMPACT AWARDS
in Sport and Physical Activity
“Promoting innovation, access and inclusion in sport and physical activity for all”

An initiative of the Global Partnership on Children with Disabilities
Task Force on Physical Activity and Sport

ONLINE APPLICATION FORM

Deadline for Applying: 31 January 2016, 12:00 PM GMT

INSTRUCTIONS
To participate in this challenge complete this form in its entirety either a) electronically on the web [below] or b) email THIS FORM it to inclusion4development@gmail.com.

If you have any questions or technical difficulties please email help@committoinclusion.org.

All fields are required

Organization or Individual Name

Name of Contact Person(s), Affiliation

Email of Contact Person (for internal use only)

Mailing address for the organization/individual representing the innovation

If you are an organization please check applicable boxes:
Non-governmental organizationSport organization/associationMunicipalitySchool/UniversityGovernmentOther

Type in "Other"

If you are an individual please check applicable boxes:
Professional in this sectorEntrepreneurIndividual with a disabilityOther

Type in "Other"

Is the organization presenting the project the owners and creators of the concept?
YesNo

Project Name/Title (max. 20 words)

Briefly describe what your project entails, including what the innovation is, how long the project has been implemented, where is it being implemented, and who is it reaching.(max. 100 words)

Describe the issue, challenge or barrier the innovation solved. (max. 150 words)

Describe why and how your concept is innovative. In other words, how is your project unique, different from other initiatives in the field and driven by original, ground-breaking ideas. (max. 150 words)

Describe how your project has fostered more inclusion of children and adolescents with disabilities in physical activity, sport, fitness, recreation and play. Be sure to include details on the current and potential reach of the innovation - how many people or organizations it has reached. (max. 150 words)

Describe how your project is sustainable. (max. 150 words)

Describe how your project can be repeated or transferred to other groups or environments to enhance long-term impact. (max. 150 words)

Describe how much it costs to implement, run or replicate your project and how many people benefit for that cost. (max. 150 words)

Describe who your partners were for developing and implementing the project and if and how you engaged with people with disabilities in the process. (max. 150 words)

In addition to completing this form, we request 1-2 photos showing your innovation in action. By submitting the photos you agree for us to use the photos in all promotional and communication activities of the Global Partnership on Children with Disabilities Task Force on Physical Activity and Sport, which includes the Commit to Inclusion website. Upload high resolution photos (upto 2MB) or email the photos to help@committoinclusion.org.

Upload another high resolution photo (upto 2MB) here.

You are also encouraged to record a 1-3 minute video that showcases your innovation. You may use a camera phone, video camera, computer camera, etc. and you will not be judged on the quality of the video. Links to video clips should be e-mailed to help@committoinclusion.org. If your video is too large to email please share it with help@committoinclusion.org via dropbox, youtube or another file upload service. In your video you should try to show what is the problem you are addressing with your innovation and what was the solution.

By submitting this form, I/we verify that I/we are the owners of this innovation and give full permission to the Global Partnership on Children with Disabilities, Commit to Inclusion campaign, UNICEF, Lakeshore Foundation, American College of Sports Medicine, the Institute for Human Centered Design, and Inclusion4development to use the information contained in the application form, in all forms of media and communications with credit given to the organization or individual submitting the application.

I agree to receive email updates from the Lead Organizations of Commit to Inclusion (International)