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NOMINATION FORM
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TYPE OF NOMINATION (please tick the box)
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TYPE OF ORGANISATION (please select one)
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*Others (please specify)
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ELIGIBILITY (please tick the box)
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*NRCF Grantees (please specify which year/cycle)
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*Non-NRCF Grantees but GEC Community Group (please specify project/programme )
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1.0) PARTICULAR OF NOMINEE
Name of Representative
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Organisation
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Address
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Phone number
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2.0) PARTICULARS OF NOMINATOR
Name
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Designation
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Mobile/Phone Number
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E-mail address
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SECTION A: MANAGEMENT
Set-up Committee/Working Group
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List of key committee member names
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Do you have Action Plan?
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If you have action plan, please provide the details long term/short term program/activity
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Good cooperation and team work
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Others, if any.
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SECTION B: ACTIVITY/INITIATIVE
B1. What are the activities/initiatives your community has carried out?
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*Others (please indicate)
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*For all the ticked activities/initiatives above, please provide the status (ongoing/stopped/paused) and the starting time (month and year)
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Where is the location of your initiative/activity?
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What is the GPS coordinate of your initiative/activity?
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B1a. If you carry out river/lake/biodiversity monitoring, how long is the river stretch/spot being monitored?
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B1a. If you carry out river/lake/biodiversity monitoring, what is the frequency of the monitoring?
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B1a. If you carry out river/lake/biodiversity monitoring, how many community members are involved (average members per monitoring)?
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B1a. If you carry out river/lake/biodiversity monitoring, how do you share your finding (e.g. WhatsApp, Social Media, RIVER Ranger website)?
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B1b. If you carry out river clean-up, what is the frequency of the gotong - royong or clean-up?
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B1b. If you carry out river cleanup, how many volunteers are involved (average per cleanup activity)?
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B1c. If you carry out waste recycling/upcycling or used cooking oil collection, what is the frequency of the activity?
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B1c. If you carry out waste recycling/upcycling or used cooking oil collection, how much wastes/used cooking oil have been collected?
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B1c. If you carry out waste recycling/upcycling or used cooking oil collection, how many total volunteers involved?
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B1c. If you carry out waste recycling/upcycling or used cooking oil collection, to whom do you sell the recycled/used cooking oil?
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B1d. If you have ongoing river education programme, what is the frequency of the programme?
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B1d. If you have ongoing river education programme, how many people (public/students/others) have participated in this programme?
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B1d. If you have ongoing river education programme, what is the main objective of the programme?
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B1e. If you have an ongoing science, technology and innovation (STI) programme, what is the type of issue (waste management, water quality deterioration, etc)?
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B1e. If you have an ongoing science, technology and innovation (STI) programme, what are the products/tools/solutions undertaken?
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B1e. If you have an ongoing science, technology and innovation (STI) programme, what are the results?
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B1f. If you have established a community garden, how big is the community garden (approximate in acre)?
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B1f. If you have established a community garden, total community members involved?
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B1f. If you have established a community garden, what are the key aspect or facilities available? (e.g. Herb garden, fish pond, recreational)
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B1f. If you have established a community garden, what are the environment-friendly features/elements set up/practices? (e.g. composting, alternative water source (like rainwater harvesting or river water), solar panels, etc.)
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B1f. If you have established a community garden, how do you share your harvest/products (e.g. sell, share among members, donate to others like charity home etc.)
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B1g. Commencement of the project/activity (since when?)
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SECTION C: IMPACT
a) Promote project ownership and empowerment among the members of the community
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b) Lead to smart partnership model including private, public and agencies involvement
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c) Improve water quality of the nearby water body (river/lake)
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d) Improve biodiversity of the nearby water body (river/lake)
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e) Improve the quality life of local community
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f) Improve the aesthetic of the environment
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g) Enhance awareness, education and capacity building of the community
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h) Establish network/peer to peer learning with other similar groups
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i) Establish alternative livelihood/revenue
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SECTION D: PARTNERSHIP/NETWORKING
D1. Please list the partners that you are currently working or have worked with (if any).
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D2a. If you have carried out awareness or sharing programmes, please list the awareness materials that have been produced (if any).
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D2b. If you have carried out awareness or sharing programmes, name the groups that you have shared your experience with.
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D2c. If you have carried out awareness or sharing programmes, what is the frequency of the above activity?
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D3. Have your initiative received any recognition or award?
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If yes, please provide details of the award (i.e. year, award and by who?)
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SECTION E: SUSTAINABILITY
E1. How does your community started the initiative?
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*Others (please state)
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How it started?
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How do you plan to sustain the initiative?
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E2. If you are selected as one of the award winners, tell us how does your organisation plan to spend the award money. (NOTE: 80% of the award money must be channeled to run the river care activity)
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Any other relevant information?
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All candidates are required to attach a simple video for evaluation.
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Please provide relevant documents, paperwork or photos (if any)
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If file size exceeds limit, please provide link(s):
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DECLARATION
Name
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Date
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