If your application is for a delegation of women, please complete this section. For individual applicants, use individual application form

Please download and fill out this document, and upload it to the file upload field below.

Upload Delegate Spreadsheet here*

1a. Please name one focal point from the delegation list above.
Enter Full name*

1b. Secure email address*: *

*A secure email address is an address you are OK to be contacted through to further discuss your application. If you feel that contact with WPHF may put you at risk we suggest that at minimum you use a secure computer, safe internet connection and open a separate, new email account and provide this address in the application instead.

Other preferable method of contact

3. Please specify the start date, the duration, the location of the event/meeting/decision-making process, and the organizers, if relevant.

Date*

Month/Day/Year

Number of days*

Location*

Organizers*

Website

Please attach either a program or agenda of the advocacy event/meeting(s)*

4. What type of direct/logistical support are you seeking?
Select all that apply*

If you have selected "flight", please provide the travel itinerary of each member of your delegation in the Excel file you have downloaded

Flight*

Local Land Travel (bus,car,train)

Visa Fees

Daily Subsistence Allowance (daily meals, incidentals, accomodations)

Access for people living with disabilities

Simultaneous interpretation

Translation of documents

Translation/interpretation needs for people living with disabilities

Other

Other (related to event)

If you selected 'translation/interpretation', please specify details of translation/interpretation (e.g. language of translation, sign language, etc.)

5. Please let us know if you have submitted a similar application to another organization, and/or received support (financial/non-financial) from another donor.*

Please note this question is for information purposes and for coordination only and is not evaluated.

Yes

If yes, please explain what will be covered and the remaining gaps:

6. Please tell us about your delegation and your experience as women human rights defenders. How have you been leading human rights and peacebuilding activities in your community together and/or individually?*

Please provide a short bio of each member of the delegation (Maximum 500 words).

7. What are the objectives of the event/meeting/decision-making process?*

Maximum 200 words

8. Please describe the role/mission of the delegation and of individual members in the event/meeting/decision-making process, and what you are seeking to influence and achieve.*

(e.g. how the delegation was formed, objectives of the delegation, etc.) Maximum 300 words

9. What are the risks you as an individual and/or as a delegation could face as a result of your participation in the event/meeting/decision-making process? How will you mitigate these risks? Please include a minimum of 2 risks and mitigation measures

Risk1*

Mitigation 1*

Risk 2*

Mitigation 2*

Risk 3

Mitigation 3