Name and Surname of the Natural Person
Organization Name (Original)
Organization Name (official English version)
Name of the Project
Name of the Statutory Representative
ID No. of Organization
Address (of the Organization)
Name and Surname of the Contact Person
Telephone No. of the Contact Person
E-Mail Address of the Contact Person
1 - The results achieved during the implementation of projects aimed at support and development of the Roma minority 2 - The implementation of projects aimed at extracurricular educational activities for children and youth 3 - The implementation or long-term support for projects aimed at social assistance and support of the Roma community 4 - The exceptional projects or long-term work which helps to improve the status and living conditions of the Roma population 5 - The protection and development of the identity and culture of the Roma minority 6 - Fostering intercultural dialogue and understanding between the Roma minority and majority population or other minorities 7 - Spreading a positive message of mutual tolerance and understanding 8 - Other
If choosing other, please specify (max. 300 characters)
1 - Non-Governmental Organization (NGO)Awarded to a non-governmental organization for the realization and demonstrated results of a distinct project for delivering support and enhancement to the Roma minority, and recognizable out-of-school educational activities for Roma children and youth. 2 - Company/Firm/Employer (COE)Awarded for activities conducted by business entities, organizations or institutions, such as: nursery school, university, research department, for outstanding activities and projects devoted to the support and enhancement of the Roma community. 3 - Municipalities and Cities (MAC)Awarded to municipalities and self-governing regions, which through their governments and combined efforts contributed to dignified integration of the Roma community and to their coexistence and understanding with the majority population. 4 - Personality (PER)Awarded to individuals who, through their activities, continuously contribute or have contributed to improving the situation of the Roma community and to the development of intercultural dialogue. 5 - Media (MED)Awarded to a journalist or mass medium for spreading positive, objective, sensitive and balanced information about the Roma minority, or media who otherwise significantly contributed to promotion of understanding and tolerance in society.
SHORT DESCRIPTION OF THE NOMINATED SUBJECT: Please describe the core activity/business activities of the organization, and/or project activity, and/or activities of the nominated subject (maximum length 800 characters)
REASONS FOR THE NOMINATION OF THE NOMINATED SUBJECT: What results has the nominated subject achieved? Why are you nominating this person/organization/project? (maximum length 800 characters)
QUANTITATIVE IMPACT OF THE ACTIVITIES OF THE NOMINATED SUBJECT: What is the impact/reach of the activities of the nominated subject? Who do the project activities impact the most? How many people are involved in the project? How many people are impacted/reached by the subject’s activities? (maximum length 800 characters)
QUALITATIVE IMPACT OF THE ACTIVITIES OF THE NOMINATED SUBJECT: What makes the activities and achieved results of the nominated subjects unique/extraordinary? (maximum length 800 characters)
TIMELINE OF IMPLEMENTATION OF NOMINATED SUBJECT’S ACTIVITIES: How long has/had the nominated subject been implementing its activities/project(s)? When did these activities/project(s) start? (maximum length 800 characters)