Our candidate, their fight Form for groups linked to a charity or an organisation This form is for groups of young people linked to a charitable institution. It is to be used to nominate a candidate for the Freedom Prize 2019, in compliance with the conditions of the Prize s regulations. This form consists of three parts. The first two are obligatory. They consist of: - a presentation sheet for your group - a questionnaire on the person or organisation you ve chosen as your candidate (natural person or organisation) and their fight The third part is optional: creating audiovisual creative work to present your candidate or artistic creative work on the candidate, their fight or the theme of freedom, as part of your application. The signed version of this digital form must be returned by email to prixliberte@normandie.fr, along with any attachments, by 15 January 2019 at the latest. A number of participating groups who have submitted high quality applications will be chosen to attend to the prizegiving ceremony of the Freedom Prize by the organising committee. This event will take place in Normandy in June 2019. 1
I. OUR GROUP: 1) INSTITUTION TO WHICH WE ARE LINKED: Charity NGO Charitable network Other: Name of the institution: Country: Address: Email address: Phone number: Area of activity: Purpose of the charity or organisation: 2) NATURE OF THE GROUP: Number of youth participants: of which: girls and boys. You can add any information below about your group for the attention of the initiative s organisers: 2
How have you heard of the Freedom Prize? At your institution By the means of communications of the Freedom Prize Which ones? By internet and social networks By the press By the word of mouth Other: 3) ADULT CONTACT OF THE GROUP: SURNAME: First name: Role: Email address: Phone number: The adult contact is a member of the participating group: Yes No 3
List of participants: SURNAME FIRST NAME Date of birth 4
SURNAME FIRST NAME Date of birth 5
II. OUR CANDIDATE, THEIR FIGHT 1) SUMMARY OF THE APPLICATION FOR OUR CANDIDATE, THEIR FIGHT Summary (maximum 1000 characters) 2) NOMINATED CANDIDATE If nominating a person Surname: First name: Year of birth: Nationality: Contact details (if possible): 6
If nominating an organisation Name: Status: Address of head office (if applicable): President: Date founded: Contact details: SHORT BIOGRAPHY OF YOUR CANDIDATE: Key dates (maximum 1500 characters) 7
3) PRESENTATION OF THEIR FIGHT: (Maximum 5000 characters) Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Nam cursus. Morbi ut mi. Nullam enim leo, egestas id, condimentum at, laoreet mattis, massa. Sed eleifend nonummy diam. Praesent mauris ante, elementum et, bibendum at, posuere sit amet, nibh. Duis tincidunt lectus quis dui viverra vestibulum. Suspendisse vulputate aliquam dui. Nulla elementum dui ut augue. Aliquam vehicula mi at mauris. Maecenas placerat, nisl at consequat rhoncus, sem nunc gravida justo, quis eleifend arcu velit quis lacus. Morbi magna magna, tincidunt a, mattis non, imperdiet vitae, tellus. Sed odio est, auctor ac, sollicitudin in, consequat vitae, orci. Fusce id felis. Vivamus sollicitudin metus eget eros. Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Nam cursus. Morbi ut mi. Nullam enim leo, egestas id, condimentum at, laoreet mattis, massa. Sed eleifend nonummy diam. Praesent mauris ante, elementum et, bibendum at, posuere sit amet, nibh. Duis tincidunt lectus quis dui viverra vestibulum. Suspendisse vulputate aliquam dui. Nulla elementum dui ut augue. Aliquam vehicula mi at mauris. Maecenas placerat, nisl at consequat rhoncus, sem nunc gravida justo, quis eleifend arcu velit quis lacus. Morbi magna magna, tincidunt a, mattis non, imperdiet vitae, tellus. Sed odio est, auctor ac, sollicitudin in, consequat vitae, orci. Fusce id felis. Vivamus sollicitudin metus eget eros. Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. In posuere felis nec tortor. Pellentesque faucibus. Ut accumsan ultricies elit. Maecenas at justo id velit placerat molestie. Donec dictum lectus non odio. Cras a ante vitae enim iaculis aliquam. Mauris nunc quam, venenatis nec, euismod sit amet, egestas placerat, est. Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Cras id elit. Integer quis urna. Ut ante enim, dapibus malesuada, fringilla eu, condimentum quis, tellus. Aenean porttitor eros vel dolor. Donec convallis pede venenatis nibh. Duis quam. Nam eget lacus. Aliquam erat volutpat. Quisque dignissim congue leo Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Nam cursus. Morbi ut mi. Nullam enim leo, egestas id, condimentum at, laoreet mattis, massa. Sed eleifend nonummy diam. Praesent mauris ante, elementum et, bibendum at, posuere sit amet, nibh. Duis tincidunt lectus quis dui viverra vestibulum. Suspendisse vulputate aliquam dui. Nulla elementum dui ut augue. Aliquam vehicula mi at mauris. Maecenas placerat, nisl at consequat rhoncus, sem nunc gravida justo, quis eleifend arcu velit quis lacus. Morbi magna magna, tincidunt a, mattis non, imperdiet vitae, tellus. Sed odio est, auctor ac, sollicitudin in, consequat vitae, orci. Fusce id felis. Vivamus sollicitudin metus eget eros. Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Nam cursus. Morbi ut mi. Nullam enim leo, egestas id, condimentum at, laoreet mattis, massa. Sed eleifend nonummy diam. Praesent mauris ante, elementum et, bibendum at, posuere sit amet, nibh. Duis tincidunt lectus quis dui viverra vestibulum. Suspendisse vulputate aliquam dui. Nulla elementum dui ut augue. Aliquam vehicula mi at mauris. Maecenas placerat, nisl at consequat rhoncus, sem nunc gravida justo, quis eleifend arcu velit quis lacus. Morbi magna magna, tincidunt a, mattis non, imperdiet vitae, tellus. Sed odio est, auctor ac, sollicitudin in, consequat vitae, orci. Fusce id felis. Vivamus sollicitudin metus eget eros. 8
4) WHY HAS YOUR GROUP CHOSEN TO SUPPORT THIS PERSON/ORGANISATION AND THEIR FIGHT? Maximum 2500 characters (fill in the form accordingly) Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. In posuere felis nec tortor. Pellentesque faucibus. Ut accumsan ultricies elit. Maecenas at justo id velit placerat molestie. Donec dictum lectus non odio. Cras a ante vitae enim iaculis aliquam. Mauris nunc quam, venenatis nec, euismod sit amet, egestas placerat, est. Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Cras id elit. Integer. Ut accumsan ultricies elit. Maecenas at justo id velit placerat molestie. Donec dictum lectus non odio. Cras a ante vitae enim iaculis aliquam. Mauris nunc quam, venenatis nec, euismod sit amet, egestas placerat, est. Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Cras id elit. Integer quis urna. Ut ante enim, dapibus malesuada, fringilla eu, condimentum quis, tellus. Aenean porttitor eros vel dolor. Donec convallis pede venenatis nibh. Duis quam. Nam eget lacus. Aliquam erat volutpat. Quisque dignissim congue leo Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. In posuere felis nec tortor. Pellentesque faucibus. Ut accumsan ultricies elit. Maecenas at justo id velit placerat molestie. Donec dictum lectus non odio. Cras a ante vitae enim iaculis aliquam. Mauris nunc quam, venenatis nec, euismod sit amet, egestas placerat, est. Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Cras id elit. Integer quis urna. Ut ante enim, dapibus malesuada, fringilla eu, condimentum quis, tellus. Aenean porttitor eros vel dolor. Donec convallis pede venenatis nibh. Duis quam. Nam eget lacus. Aliquam erat volutpat. Quisque dignissim congue leo Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. In posuere felis nec tortor. Pellentesque faucibus. Ut accumsan ultricies elit. 9
5) MAIN DOCUMENTARY SOURCES USED TO PREPARE YOUR APPLICATION: Be sure to be precise when listing your references so that they can be found easily. Bibliography (maximum 5 references): Website bibliography (maximum 5 references) : If there are any documents you want to bring to the attention of the panel of judges in support of your application (texts, photos, videos, reports of meetings or visits), please send them with this form. 10
III. CREATIVE WORK (optional) To encourage multidisciplinary educational work, you can, if you wish, create audiovisual and/or artistic creative work. This creative work will be in addition to the reasoned research work which you have carried out and will support your application. It should be sent by email with this form. Work will not be assessed by the Freedom Prize s panel of judges but may be the subject of specific evaluation. Although optional, this creative work is strongly encouraged. It may be taken into consideration by the organisers when inviting participants to the prizegiving ceremony of the Freedom Prize in Normandy in June 2019. a. AUDIOVISUAL CREATIVE WORK This involves creating a video lasting a maximum of 2 minutes to present your candidate and their fight. If your candidate is one of the 3 public figures or organisations chosen by the panel of judges, your video may be used to promote their fight during the voting stage. If your video is not in French or English, you must include subtitles in one of these two languages. At the end of your video, credits must display the name of your relevant structure, the youth participants and the different credits (music, video, etc.) if necessary. b. ARTISTIC CREATIVE WORK This involves expressing your creativity by creating artistic work of the medium of your choice (writing, photography, visual arts, etc.) on the theme of freedom or your candidate and their fight. Depending on its relevance and quality, some of this creative work may be put online on the Freedom Prize s website or presented at the Prize s prizegiving ceremony. When this work has been sent, you will receive an acknowledgement of receipt, along with a request for your authorisation to use this work as part of the Freedom Prize. This authorisation must be completed by each member of your group or by minors legal guardians. 11
Respect for intellectual property: When producing a video or any other artistic medium, Freedom Prize participants must reflect on the question of the related rights of each document used in their work: copyright and image rights. So the authorisation to use all or part of content protected by intellectual property laws (texts, music, films, photos, etc.) must imperatively have been obtained from the rights holder (the author) or from its beneficiaries and, where appropriate, the authorisation of the person featuring in the reproduced image should also have been obtained. The precise source of the document used as well as the name of the author must appear close to it or in the credits of a video. If participants use royalty-free materials, their source and author should also be mentioned. The organisers of the Freedom Prize cannot be held liable if these authorisations have not been obtained prior to any insertion in creative work. Data protection: The data collected in this form is processed to assist with the organisation of the Freedom Prize by the Normandy Region. The data is shared with the organisers of the event and is stored for a year after the event. Pursuant to the European Data Protection Regulation and the French Data Protection Act of 6 January 1978, you have the right to access, rectify, delete and object to the processing of your personal information; you can exercise these rights by contacting the Data Protection Officer: dpo@normandie.fr For more details on data processing, please refer to the Rules of Procedure. 12