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Email: contact@energyglobein!o
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PART I - GENERAL CONTACT INFORATION
!.! CONTACT "ETAIL# OF ORGANI$ATION
0only rele1ant i! submitted by an institution2com3any2organi4ation 5 indi1iduals 3lease com3lete 167
Full Name o! institution2
com3any2organi4ation:
)treet and street number:
#ostal code: (o8n:
'ountry: %9cial home3age:
(ele3hone:
0including country code: no
brackets or slashes7
%9cial com3any
email:
0ie
in!o@e;am3lecom3anycom7
!.% IN"I&I"'AL CONTACT "ETAIL#
First name: )urname:
Academic title:
Gender: 03lease mark 8ith
;7
0 7 ,ale 2 0 7 Female
)treet and street number:
#ostal code: (o8n:
'ountry: Email 0o! contact 3erson7:
(ele3hone:
0including country code: no
brackets or slashes7
,obile #hone:
0including country code: no
brackets or slashes7
PART II - PRO(ECT INFORATION ) O&ER&IE*
%.! GENERAL INFORATION
#ro<ect title:
)tatus o! im3lementation:
03lease mark 8ith ;7
0 7 #lanned
0 7 -m3lemented
3ro<ect or ongoing
3ro<ect
'ountry2'ountries o!
im3lementatio
n:
%.% PRO(ECT #'AR+
#lease summari4e 0=1>51? lines,7 8hat the 3ro<ect is about and 8hat ma<or outcomes ha1e been achie1ed 03lease state concrete @gures7,
es3ecially any rele1ancy in regard to en1ironmental 3rotection, im3ro1ement o! li1ing and2or economic conditions, a8areness creation,
emission reduction, rene8able energy, energy and resource e9ciency, counteracting climate change, etc: #lease use a !ormal 8riting
style as this summary 8ill be 3ublished in our online database 0use your2your organi4ationAs name in the te;t and do not use e;3ressions
like "e, -, our com3any, etc7
PART III ) "ETAILE" PRO(ECT INFORATION
#lease 3ro1ide a co,plete an- proper -e.cription at t/e 01ry2. re31e.t
A4 INITIAL #IT'ATION AN" CONTE5T OF T6E PRO(ECT/INITIATI&E
#lease 3ro1ide in!ormation 0ma; hal! a 3age, 6>>> characters7 on the initial situation 03roblems, challenges7 be!ore the 3ro<ect 8as im3lemented
Be3ending on the ty3e o! 3ro<ect, 3lease include the en1ironmental, ecological, economic, social, energy or other rele1ant conte;t o! your country
74 "E#CRIPTION OF PRO(ECT O7(ECTI&E AN" OTI&ATION
"hat 8as your o1erall moti1ation to start this 3ro<ect and 8hat ha1e been the 3ro<ectAs ob<ecti1esC 0ma; hal! a 3age, 6>>> characters7
C4 #COPE AN" IPLEENTATION ACTI&ITIE#
#lease describe in more detail 0ma; hal! a 3age, 6>>> characters7 the sco3e o! the 3ro<ect and the ma<or acti1ities that ha1e been conducted !or its
im3lementation
"4 INNO&ATION
#lease describe the inno1ati1e as3ects o! your 3ro<ect under consideration o! the technological standards and conditions 0ie regional conditions,
social conditions, economic conditions or 3olitical situation7 o! your country 0ma; hal! a 3age, 6>>> characters7
E4 IPLEENTATION AN" CO#T#
5 For 3ro<ects including a tec/nological co,ponent: #lease describe the technology a33lied, as 8ell as the costs and economic bene@ts 0ma; hal! a
3age7
5 For 3ro<ects including a .ocial co,ponent: #lease describe the a33roach that you ha1e chosen as 8ell as the social im3act o! your measures had
on 8hich target grou3s 0ma; hal! a 3age, 6>>> characters7
F4 "E#CRIPTION OF AC6IE&E" RE#'LT#
#lease describe in detail all direct and indirect results Be3ending on your 3ro<ect, 3lease !ocus es3ecially on en1ironmental and2or social and2or
economic im3acts resulting !rom the im3lementation o! your initiati1e "here 3ossible, 3lease include @gures 0ie number o! 3eo3le trained or <obs
created, tons o! '%
6
a1oided, m
D
o! 8ater treated, ,"h o! rene8able energy 3ro1ided, energy e9ciency be!ore2a!ter reno1ation, tons o! 8aste
collected2reduced, number o! trees 3lanted, etc7 or descri3tions on ho8 3eo3le or en1ironment ha1e other8ise bene@tted !rom your 3ro<ect 0ma;
hal! a 3age, 6>>> characters7
G4 REPLICATION POTENTIAL 8O"EL C6ARACTER4
#lease describe the re3lication 3otential o! your 3ro<ect in other regions or countries 0ma; hal! a 3age, 6>>> characters7
PART I& ) P6OTO# AN" PRO(ECT "OC'ENTATION
#lease send 45E 3hotos in 3rint Fuality 0=4>> kb G D ,+ 3er 3icture7 8hich document your 3ro<ect 8ell #re!erred @le !ormat <3g or gi!
Hou can also u3load additional 3ro<ect material
*3load these materials as 3art o! your online5submission on 888energyglobein!o23artici3ation2
PART & ) FINAL INFORATION AN" AGREEENT#
9.! 6O* "I" +O' 6EAR A7O'T T6E ENERG+ GLO7E A*AR":
#lease mark all ans8ers that a33ly 8ith ;
0 7 ,ail by Energy Globe 0 7 #rint media 0 7 Friends2'olleagues
0 7 'all by Energy Globe 0 7 Facebook 0 7 Google
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0 7 'ontact by Energy Globe Ambassador 0 7 %ther
9.% )*##%$( +H ENE$GH G/%+E #A$(NE$
-n the !uture there is a 3ossibility that selected 3ro<ects 8ith e;ce3tional 3ros3ects are su33orted by an ENE$GH G/%+E #artner on their 8ay to8ards
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the yes @eld 8ith ;
0 7 Hes 2 0 7 No
9.; #TATEENT OF AGREEENT 8ACCEPTANCE I# O7LIGATOR+ for .1b,i..ion4
+y 3artici3ation in the ENE$GH G/%+E A8ard com3etition - agree to the electronic 3rocessing, sharing 8ithin the ENE$GH G/%+E 3artner net8ork and
3ublication o! my 3ro<ect
- here8ith declare, that my statements regarding the submitted 3ro<ect are com3lete and correct and may in 3art or in total be 3ublished by Energy
Globe Energy Globe shall not be liable !or the correctness and com3leteness o! these statements -n case o! any la8 suits or litigation, eg regarding
co3yright or 3ublishing right, the submitter is res3onsible that Energy Globe shall not be in1ol1ed in any such la8 suits or litigations (he submitter
shall in any case com3letely indemni!y Energy Globe against all eJects resulting !rom such la8 suits or litigations +y marking the yes @eld 8ith ;, -
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corres3onding @eld 8ith ;
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T/an< yo1 for co,pleting t/e re31ire- infor,ation.
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For organi4ational reasons 3lease do not send this @le 1ia email Hou can sim3ly co3y23aste the entered in!ormation 8ith
'trl5'2'trl5I into the online !orm (hank you !or your su33ort
A!ter submitting your 3ro<ect online, plea.e c/ec< w/et/er we /a=e recei=e- it .1cce..f1lly>
1 Fill in all reFuired te;ts and u3load all documents and click at the ?#1b,it application@- 71tton. 0#lease see
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)3am@le7
)ub<ect o! this email: Hour 3ro<ect a33lication has been success!ully recei1ed 0-B: A"B>>>>7
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