UNA-USA Post-2015 Grant Application

Contact Information:

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* 1. Individual Completing Application:

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* 2. Chapter or Division Name:

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* 3. Chapter or Division President:

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* 4. Contact Information

Address 1

Address 2

City

State

Zip

Phone

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* 5. Number of Members:

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* 6. Average Event Attendance:

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* 7. Typical Event Locations (Such as, but not limited to: hotels, restaurants, college/universities, homes, etc...)

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* 8. Does your Chapter have an Area COO?

Yes

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* 9. Does your Chapter partner with local NGOs?

Yes

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* 10. If yes, please list NGOs:

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* 11. Has your Chapter held events at a local college or university?

Yes

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* 12. If yes, please list colleges/universities:

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* 13. Has your Chapter conducted programming on the Post-2015 process in the past?

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* 14. Which grant is your chapter/division applying for?

$3,000

$1,000

$500

$250

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* 15. How will your Chapter identify and invite local NGOs to participate in this discussion?

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* 16. How will your Chapter recruit "topic experts" to lead discussions? (A "topic expert" should be prepared to lead a small group discussion)

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* 17. Chapter Consultations will occur between September - November, 2014. Please list the months and/or dates that work best for your Chapter.

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* 18. How will an official consultation benefit your Chapter? Your Community?

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* 19. Please select 1-4 goals you would like to address in your activities

End poverty in all its forms everywhere

End hunger, achieve food security and improved nutrition, and promote sustainable agriculture

Ensure healthy lives and promote well-being for all at all ages

Ensure inclusive and equitable quality education and promote life-long learning opportunities for all

Achieve gender equality and empower all women and girls

Ensure availability and sustainable management of water and sanitation for all

Ensure access to affordable, reliable, sustainable, and modern energy for all

Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all

Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation

Reduce inequality within and among countries

Make cities and human settlements inclusive, safe, resilient and sustainable

Ensure sustainable consumption and production patterns

Take urgent action to combat climate change and its impacts*

Conserve and sustainably use the oceans, seas and marine resources for sustainable development

Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss

Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

Strengthen the means of implementation and revitalize the global partnership for sustainable development

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* 20. Please explain why your chapter selected the above goals to focus on and why the issues are important to your community.

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* 21. We agree to work with a member of UNA staff, UN Foundation campaigns, and other partners identified by UNA to implement this event.

Yes

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* 22. If a Division, we will include every Chapter within the Division in this event.

Yes

Not a Division