Submission Form - EU Health Award for NGOs

1. INFORMATION of the ORGANISATION

CONTACT PERSON :
ADDRESS of the organisation :
At which level is the applicant organisation acting
Space for maximum 2000 characters (without spaces).
Space for maximum 2000 characters (without spaces).

2. GENERAL INFORMATION ON THE EXPERIENCE OR INITIATIVE

Please fill in as appropriate
Initiatives can be ongoing or must have been started on any date from November 2011, the date of the publication of the EU Action Plan against the rising threats from AMR, onward.
Ongoing
(Maximum 500 characters without spaces)
(Maximum 1000 characters without spaces)
Space for maximum 4000 characters (without spaces).
(Maximum 10 pages)

This summary report of maximum 10 pages should contain at least the following parts: case study, action proposed, methodology, results and conclusions. Your report should demonstrate how your initiative reduces AMR threat to human health.

It should also cover explicitly the award criteria of technical quality: relevance, effectiveness, transferability, sustainability, intersectoral collaboration and innovation and creativity. Please have a look at the criteria page for a detailed explanation of the technical quality award criteria.

Space for maximum 1000 characters (without spaces).

To finalise your application, you will need to sign and date the Declaration of Honour and to mail it in by post to the following address:

European Commission
Directorate General for Health and Food Safety
Directorate for Public Health, Country Profiles and Crisis Management
Unit C4 Health Determinants and Inequality
to the attention of:
The EU Health Policy Platform team
HTC (Hitech) Building
11 Eugene Ruppert Street, Gasperich
L­2453 Luxembourg
Luxembourg

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