Miteri Ganga Devi Peace (MGDP) Award Nomination

Form

1) Nominee:

Name (Block Letter): ………………………………………………………………………..

Address: ………………………………………………………………………….

Recent Affiliation (if associated with any organization/community groups/networks):

………………………………………………………………………………………………………………………

Title of the Position: ………………………………………………………………………….

Date of Affiliation: ………………………………………………………………………….

Contact No.: ………………………………………………………………………….

2) Nominated By:

Name: ……………………………………………………………………………………….

Organization: ……………………………………………………………………………………….

Title: ……………………………………………………………………………………...

Address: ……………………………………………………………………………………….

Phone: ………………………………………………………………………………………..

Mobile: ………………………...…………………………………………………………..

E- mail: ………………………………………………………………………………………..

Relation to the nominee (mention how you know the nominee):

………………………………………………………………………….

3) How did you get information about the Miteri Ganga Devi Peace Award?

4) Provide summary of the nominee's background and career, highlighting

contributions and key achievements as a peace leader in community, district

and country (no more than 300 words).

5) Explain your motivation to nominate this person, and present evidence and

driving force of the nominee's contribution (no more than 300 words).

6) Explain the leadership potential, continuity of service and what difference

this award can make to the nominee's future work.

The signature below signifies that the information included with this nomination is accurate

and that the nominator and nominee may be contacted for additional information if needed.

Nominator's Signature: …………………………………………………………………………….

Date: …………………………………………………

All nomination materials must be submitted electronically to mgdpaward.awon@gmail.com by

30th August 2015. Thank you for your submission!

Action Works Nepal (AWON) proudly announces the nomination of Miteri Ganga Devi Peace Award, 2015.

The "Miteri GangaDevi Peace Award" is founded by Ms. Radha Paudel, a peace leader, in the memory of her mother late Ganga Maya Paudel and her father Mr.Devi Prasad Paudel, who always inspires her to devote her life for poor and marginalized people. In September2014, Radha's book "Khalanga ma Hamala" (Attack on Khalanga), her diary as a war survivor was awarded Madan Puraskar(Prize) 2070. On the occasion of International Peace Day, 21 September 2014, she announced this award from Khalanga, Jumla. She established this award by contributing 50% of the Madan Puraskar in order to honor two community peace leaders every year: a woman and a man from across the country. The award will be announced each year on occasion of International Peace Day on 21 September.

This award is an honor to inspire the community peace leaders who are working for change and development, based in the communities, and role models and change makers, but often go unnoticed. Award winners are regarded as role models and peace leaders, so it is important that the award selection process recognize the achievements of individuals from diverse groups, communities and the impacts they have been able to make in development and peace culture of the society.

This award will encourage the community leaders to continue and advance their journey for and development in their community and also inspire youths to pursue similar path. This award aims to start a culture of peace where everyone can contribute; join together for peace irrespective of the region, religion, age, caste and ethnicity, and gender. This Award will be provided every year on International Peace Day (21st September) beginning from 2015.

Eligibility criteria for the nominees:

All nominees must be local natural leaders from the grassroots level. Although not identified for their works in the national level, they and their contribution to their communities must be valuable for peace and development.

They must have inspiring stories behind their continuous journey for peace. They must have strong commitment to work for peace and demonstrate their useful

ideas and learning to other communities. Nominees must be a citizen of Nepal. S/he must be working tirelessly and influencing the local communities for peace and

development. Only individuals, and not teams, are eligible for this award. An individual may receive the award only once in their lifetime. Availability to attend the awards ceremony is not an eligibility requirement.

To nominate an individual for this award, please complete the form and send it along with a

nomination letter and supporting materials by 30th August 2015 to

mgdpaward.awon@gmail.com

Your nomination package must include the following:

1) Required: Signed Nomination Form,

2) Required: A resume/profile, action oriented photographs (at least three), 1-2 minute

video (if available) and news coverage (if available) for the person being nominated.

3) Required : Letters of recommendation from some organization/network or

respective VDC office

4) Optional: Any other supporting documentation which you feel is appropriate.

5) All nomination materials must be received by 30th August 2015 for consideration for

this year's award. Nominations are accepted on a rolling basis, for a month every

August (starting from 1st August to 30th August). The nomination form for the

MGDP Award will be announced on the official website

(www.actionworksnepal.com) of Action Works Nepal from 1st August.

All nominations will be acknowledged and will be documented for two years. A panel of judges

will do intensive analysis and interviews as per the guidelines of MGDP Award and announce

the winner by 15thSeptember each year.