Access It - 2009 Nomination Form

Please select an award for your nomination ACCESS-IT@Home This award will recognise an ICT based project, product or service that advances independent living for people with disabilities or elderly. ACCESS-IT@Work This award will recognise an ICT based project, product or service that facilitates persons with disability to work independently. ACCESS-IT@Learning This award will recognise an ICT based project, product or service that facilitates persons with disability or elderly to get educated in an affordable, accessible, usable and efficient manner. ACCESS-IT@Web2.0 This award will recognise a project, product or service that advances accessibility on web 2.0.

Project / Product or Service for nomination Please provide the Name of Project/Product or Service that is nominated (if applicable). Name

Organisation Details Please provide the following details for the organisation that is responsible for this Activity (Project / Product or Service): Name of Organisation (required) Address (required) City (required) PostCode (required) Country (required) Web address: http://

Contact Person Please provide the following details for the Contact Person that is responsible for this Activity (Project / Product or Service) Title (required) Name (required) Last Name (required) Position (required) Phone (with country code) (required) Mobile (with country code) Email (required)

Relevance Please describe your activity (product, project or service) and why it is relevant for the selected award. Try to be concise.(500 words) (required) Words left:

Impact In order to assess the impact of your activity (project, product or service) for the disability or elderly community, please tell us what difference has it made in their life. Also, please explain briefly how do you know it has made a difference? (300 words) (required) Words left:

Openness and Affordability The successful activity (project, product or service) will be measured upon the ease by which others can replicate or learn from the experience. This may include affordability for use by the disability or elderly community. Please give details on its usage cost and how you would encourage replication and learning from your experience including extension to different target groups or different countries etc (300 words) (required) Words left:

Resource Sources Please provide us any online reference sources (online videos, online demos, etc) that we can consult in order find out more about your activity (project/product or service). (required)

Referees Please provide the contact details of at least of one referee so that we can contact who have had experience of your activity.

Contact Details Person 1 Title (required) Name (required) Last Name (required) Position (required) Phone (with country code) Mobile (with country code) Email (required)

Contact Details Person 2 Title Name Last Name Position Phone (with country code) Mobile (with country code) Email

Access It - 2009 Nomination Form

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2009 Nomination Form

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