100% of survey complete.
This form is designed to map the agencies/organizations activities. It is designed to have geographical and timely information on each activity. This will enable us to have a sharable platform and better assess future interventions. Be aware that activities with different nature need to be logged as a separate event/record.

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* 1. Date of activity

Date

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* 2. Implementer of the activity
Kindly provide us with the Name of Agency/ Organization

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* 3. Status of Activity
Kindly specify the status of the activity

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* 4. Cluster/ Sector
Kindly specify under which Sector

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* 5. Activity details
Kindly provide us with more details

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* 6. Type of Activity
Kindly indicate the type of activity, Select other for unlisted activity

 
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* 7. Beneficiaries reached
Who are the beneficiaries (i.e. Children, injured, displaced, etc.)

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* 8. Number of beneficiaries
What is the number of beneficiaries

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* 9. Governorate/locality *
Kindly indicate in which governorate or/and locality

  Gaza Khan Yunis Deir al Balah North Gaza Rafah
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* 10. More details on location:
In case you have more accurate location description( i.e schools, hospitals)

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* 11. Contact person
Please provide contact information

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