Feel free to fill in this form in French, Dutch or English.

* 1. PARTNERSHIP

* 2. Impact zone of the partnership.

* 3. To which Sustainable Development Goals does the partnership contribute?

* 4. Explain the specific context in which you carry out the project: explain the problem your project helps resolve and to what extent your solution is innovative. Max.100 words.

* 5. Describe how the project is beneficial to society. We define social impact as the effect on the beneficieries of the partnership and society in general (community, environment, etc.). Use quantitative and qualitative data (i.e. number of direct and indirect beneficiaries). Max.100 words.

* 6. Logo of the partnership.

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* 7. CIVIL SOCIETY PARTNER

* 8. Logo of the civil society partner.

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* 9. Brief description of the civil society partner.

* 10. Contribution to the project: what resources were made available to the project (human, financial, in kind,...)?

* 11. BUSINESS PARTNER

* 12. Logo of the business partner.

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* 13. Brief description of the business partner.

* 14. Contribution to the project: what resources were made available to the project (human, financial, in kind,...)?

* 15. OTHER PARTNER

* 16. Logo of the partner.

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* 17. Brief description of the partner.

* 18. Contribution of the partner to the project: what resources were made available to the project (human, financial, in kind,...)?

* 19. Additional links.

* 20. Additional attached file.

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