FORM TO BE COMPLETED AND RETURNED BEFORE 15 DECEMBER 2019 to [email protected]

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Name of the Mayor ……………………………………………………………….

Address:........................................................................................................................................

Country:.........................................................................................................................................

Website:.........................................................................................................................................

ELDW editions in which you participated in:..................................................................................

Contact person:

NAME, first name:..........................................................................................................................

Fonction :.......................................................................................................................................

Phone number:..............................................................................................................................

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

1) What are your motivations to request the Partner of the ELDW title?

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2) Did your municipality allocate a specific budget for citizens’ participation (including the ELDW activities)? Describe

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3) Did you carry out several specific activities linked to the leading theme of the year? Describe

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4) Did you organise an event with a pan-European dimension?

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5) How do you consider your activities as inclusive? Did they reach out different groups of citizens and minorities/ underrepresented groups (children, women, Roma and Travellers, people with a disability, migrants, etc.)?

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6) How did you promote the engagement of young people and youth organisations?

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7) To what extent are the implemented initiatives sustainable?

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8) In what way are your initiatives innovative?

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Optional questions

9) Did you name a personality with local influence as « Voice of the ELDW » (Name and function) to promote the initiative?

10) Have you used the ELDW network to share knowledge, experience and good practices with other municipalities? If yes, with which municipalities and on which topic?

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Appendix to attach if available

- allocated budget for the ELDW activities

- pictures that show the promotion of the ELDW made during the activities (visual identity) and events

- impact assessment on the initiatives

We kindly remind the applicants that all their activities should be uploaded and described under their municipality profile on the ELDW website.