A P P L I C A T I O N F O R M – C A T E G O R Y I IC I V I T A S ‘ T A K E - U P ’ A W A R D

Eligibility: The CIVITAS Award is open to all towns and cities that have signed the

CIVITAS declaration and are a member of the CIVITAS Forum Network. If your town/city is not yet a Forum member, please complete and sign the CIVITAS Forum Declaration.

No more than one application per category can be submitted.

Evaluation criteriaTo be rewarded, your application should refer to a single or an integrated set of innovative sustainable urban mobility measures that your town/city has successfully transferred to another. The trial phase of the demonstrated measure(s) should have been recently completed or near to completion. Applicants should indicate why the measure (package) was transferred; how they identified the competencies needed to transfer the measure to the ‘take-up’ city by looking at other examples of best practice; how the process was successfully managed; and what the results have been so far.

Selection ProcessThe category II award winner will be selected by the CIVITAS Award Jury, based on the merit of its application.

Please send your application form via e-mail to the CIVITAS Secretariat at the following address, with “CIVITAS Award

Category II” placed within the subject of your message:

secretariat@civitas.eu

The deadline for entries for this award has been extended to 31 July 2018!

Applications will be collected and forwarded to the CIVITAS Award Jury for evaluation and then put a vote. A decision will be reached by 3 September 2018. You will be informed accordingly in order to begin preparing for the

Award ceremony in Umeå on 20 September 2018.

APPLICANT DETAILSTown/cityCountryStreet / Post box

Post code

Contact personTelephoneEmail

JUSTIFICATIONPlease answer the following questions using no more than 250 words for each answer. The insertion of images and hyperlinks are allowed.

Please describe your single or an integrated set of innovative sustainable urban mobility measures and the benefits derived by the recipient and (where possible) citizens. (max. 250 words)

Please tell us about the ‘take-up’ process referring to the evaluation criteria above.

Please describe how your partner successfully transferred your measure(s) and any particular challenges that had to be overcome. Please provide evidence, such as photos, reports, articles etc. (max. 250 words)

CIVITAS AWARDS 2018 • APPLICATION FORM 2 • Page 2 of 2