Livelihood Mainstreaming Actors Information Sheet

Livelihood mainstreaming Actors Information Sheet

After presentation of HI livelihood project, fill in this information sheet together with the identified actor

Name of your institution: ………………………………………………………………….. Acronyms: ………………………………...

Type of institution: - Ahcenese Non Governmental Organization □ - Indonesian Non Governmental Organization □ - International Non Governmental Organization □ - Governmental Agency □ - State Institution □ - Private Company □ - UN Organization □ - Other (please precise) ………………...……………………………………………

Department: …...…………………………………………………………………………… Address: …………………………………………………………………………………… ……………………………………………………………………………………………… Website: …………………………………………………………………………………… Main Contact Person: ……………………………………………………………………… Email: ……………………………………………………………………………………… Telephone: …………………………………………………………………………………. Fax: ………………………………………………………………………………………... Mobile phone: ……………………………………………………………………………...

Your activities related to Livelihood Support: Ending date (if necessary) - Psychological and/or social support □ ………………………

- Basic Soft skills trainings □ ………………………

- Small Business Management trainings □ ………………………

- Vocational Trainings □ ………………………

- Capital support □ ………………………

- Job placement □ ………………………

- Market Study □ ………………………

- Other (please precise) …………………………… ……………………… Do you focus on specific types of projects? - Agriculture □ - Aquaculture □ - Handicraft □ - Livestock □ - Small Business □ - No specific □

Do you have any specific targeted public? - Women □ - Tsunami affected people □ - Vulnerable people □ - No specific public □ - Other (please precise) ……………………………………………………………

Can you propose individual support or only group support? - Individual only □ - Group only □ - Both □

Do you have any limitations in Aceh geographical area? - Tsunami affected areas □ - Post conflict areas □ - Specific districts* (please precise)………………………………………………... ………………………………………………………………………………………

*Regarding more precisely the district of Aceh Besar: - The whole district of Aceh Besar □ - Indrapuri □ - Seulimeum □ - Sukamakmur □ - Mesjid Raya □ - Ingin Jaya □ - Darul Imarah □

Do you have any tools for selection process and accompaniment of beneficiaries?

Yes □ No □

Can you share it with us? (Enclosed to the document)

Yes □ No □ If you are providing capital support for livelihood project, could you precise if it is: For individuals or groups of people, limitation in amount, interest rate, other criteria, directly or through partner organization…?. Ending date (if necessary) - Cash grants □ ……………………… ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… …………………………………………………………………………………………

- Assets recovery □ ……………………… ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… …………………………………………………………………………………………

- Seed Capital □ ……………………… ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… …………………………………………………………………………………………

- Revolving funds □ ……………………… ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… …………………………………………………………………………………………

- Micro Credit □ ……………………… ………………………………………………………………………………………… ………………………………………………………………………………………… ………………………………………………………………………………………… …………………………………………………………………………………………

Would you be interested in working in collaboration with us to include people with disabilities within your programs? Yes □ No □

Do you need some more information about what we are doing in the field of livelihood and potential collaboration? Yes □ No □

In which area do you think we could collaborate? Referral □ Sharing of information □ Identification of entrepreneurs (apprenticeship) □ Provide behavioral soft skills □ Identification of market opportunities □ Provide technical support □ Please give details on the activities you have mentioned above or any other activities of interest you would like to inform us about:

Met by:…………………………….. On:……………………………. In:…………………………………………………………………………………………...