ASA Partner Application Form
ASA Partner Application Form version 1.1 last updated 14 August 2013
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Partnership Application Form The Amphibian Survival Alliance is a partnership acting for amphibians, for the environment and for people. The secretariat at the heart of the Alliance plays a coordinating role to help strengthen and enable partners to pursue shared priorities, programs and policies to advance amphibian conservation goals. This form aims to provide the secretariat with the information needed to ensure that partnerships are developed in such a way as to maximize benefits for the Alliance and the individual Partners. In collating this information the Alliance will be able to act with greater efficiency and have the ability to utilize the aggregate numbers to represent the amphibian conservation community at the global negotiation table. Please complete the form trying to answer as many questions as possible. Joining the Alliance is not dependent on answering all the questions, but by providing as much information as possible you will contribute to making the Alliance a much more effective and efficient partnership. On completion of the form your application will be reviewed and a member of the Alliance secretariat will contact you with a decision within 30 days of receipt of the completed application. In the event that further information is required a member of the secretariat will contact you. Once the application has been accepted a member of the secretariat will be designated as your focal contact point and will help to develop a partnership model that will work best for your organization. 1 institutional Infomation
ASA Partner Application Form version 1.1 last updated 14 August 2013
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Institutional Information 1.1 Organization’s Name 1.2 Countries you currently operate in:
1.3 Legal Status of operation (if you work in multiple countries with different status, please let us know under what status you work in which country):
1.4 Founded in (date or year): 1.5 Members (number of members, if membership is supported): 1.6 Number of Staff: 1.7 Address: 1.8 Email: 1.9 Web: 1.10 Facebook: 1.11 Twitter: 1.12 Additional Social media:
ASA Partner Application Form version 1.1 last updated 14 August 2013
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Institutional Information 1.13 Vision of the organization:
1.14 Mission of the organization
1.15 Logo (please send us a file in the highest available resolution with portrait and landscape version if available)
You will need to appoint two focal contact points (name, job title and email) one to cover technical requests and one to cover all media relations (we understand that in some cases this might be the same person): 2.1 Technical request focal point 2.1.1 Name: 2.1.2 Job title: 2.1.3 E-mail: 2.2 Media relations focal point 2.2.1 Name: 2.2.2 Job title: 2.2.3 E-mail:
ASA Partner Application Form version 1.1 last updated 14 August 2013
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Your Work Please indicate below how you are currently working or will work in the near future toward the goals and objectives of the Alliance by answering the following questions. 3.1 Is your institution working with (select all that apply): amphibians
ecotoxicology
threatened species (nationally/globally)
captive breeding of amphibians
habitat conservation
reintroduction of amphibians or threatened species
sites containing threatened species
red listing
outreach campaigns for amphibians
taxonomy and systematics
education programs on amphibians
genome banking
amphibian trade related issues
species conservation strategies
climate change issues relating to amphibians
amphibian surveys and monitoring
infectious disease
capacity building programs
policy issues relating to amphibians 3.2 Please specify the amphibian species you are working with (include the scientific names, please):
3.3 Please specify which non-amphibian threatened species you are working with:
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Your Work 3.4 Do you provide grants? Y/N 3.4.1 If so what grants do you currently offer and what is the approximate total amount per year?:
3.4.2 What additional capacity building investments do you currently make? Please define and include an approximate dollar value:
3.5 Describe any recent achievements (if any) that have helped further amphibian conservation, research or education, and any additional details with regards to your choices above to help us get a clearer picture of what your institution does (or intends to do):
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Your Work 3.6 How could the Alliance assist you in your efforts to further protect amphibians? Please select all that apply: connecting you with amphibian experts additional visibility for your work promoting specific projects related to amphibians getting access to knowledge and expertise on amphibian biology and conservation connecting your institution with other partners and stakeholders. 3.6.1 Please specify which partners/stakeholders you would like to be connected with:
3.6.2 Please describe other ways in which you think that the Alliance could assist you:
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You and the Alliance 4.1 What actions would you like to see the Alliance act on as part of short, medium and long term strategy?
4.2 Can you recommend other organizations that should be invited to join the Alliance?
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You and the Alliance Please read and accept the attached Alliance LoC, including explicit commitments that your institution is taking in the section highlighted in yellow. Send us a signed copy (ideally electronically), and we will return you an electronic copy with the signature of the ASA Chair added to it and sealing the partnership. We strongly encourage you to make a commitment, which should be a direct action somewhere to protect species (even if this are the very initial steps, and in its broadest sense as to include assessments, publications describing species status, development of species action plans, etc). We expect you would have been doing these things anyway, but capturing them in the context of this initiative is important from a communications perspective. Please try to provide a precise measurable goal and financial sums if possible. In addition to the above commitment all Partners agree to act on ASA priority actions. Once accepted into the Alliance your designated Alliance focal point will work with you to identify the ASA priority actions that best fit with your organizational strategy and resources and will connect you with other partners working on the same priority actions. This should be a positive initiative, aiming to show that conservation for amphibians works. We would be very grateful if you could share some of your success stories on amphibian conservation with us.
THANK YOU FOR YOUR SUPPORT
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Supporting Notes The notes included here are aimed to provide supporting information for the completion of the ASA Partnership Application Form. Please note that once completed a member of the Alliance secretariat staff will review the information to ensure we have sufficient details to move forward. If you are unsure of what is required please leave the space blank or complete as best as possible and we will work with you to complete the information at a later date. 1. Institution’s information 1.1. Organization’s Name - Please provide the full name of your organization 1.2. Countries you currently operate in - Are you global or specific to a certain region? 1.3. Legal Status of operation - If you work in multiple countries with different status, please let us know under what status you work in which country. 1.4. Founded in (date or year) - This helps us learn a little more about your history as an organization. 1.5. Members - Number of members, if membership are supported in by your organization. This number will help demonstrate the reach of the Alliance. 1.6. Number of Staff - This number once again shows the combined resources of the Alliance model. 1.7. Address - This will be provided on your online profile so that people can contact you directly regarding actions you are involved in. 1.8. Email - As above 1.9. Web - As above and this will allow us to promote your website through our social media platforms. 1.10. Facebook - Providing your social media information will help us better promote your efforts to the rest of the community.
1.11.
Twitter - As above.
1.12.
Additional Social media - As above.
1.13. Vision of the organization - Helps us understand how your vision works with that of the Alliance. 1.14. Mission of the organization - As above. 1.15. Logo - Please send us a file in the highest available resolution with portrait and landscape version if available. We will use your logo on our website, social media and various publication promoting your contribution to the Alliance. 2. Contact points You will need to appoint two focal contact points (name, job title and email) one to cover technical requests and one to cover all media relations, we understand that in some cases this might be the same person. Once you have been accepted into the Alliance the secretariat will work with these individuals to ensure the most beneficial partnership is developed. 3. Your links with the ASA Please indicate below how you are currently working or will work in the near future toward the goals and objectives of the Alliance by answering the following questions. 3.1. Is your institution working with: 3.2. Please specify the amphibian species you are working with (include the scientific names, please). Feel free to highlight a few key species if you are working in regions with large numbers of amphibians. If needed a member of the ASA team will reach out to
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you for more information. 3.3.Please specify which non-amphibian threatened species you are working with. This information helps us demonstrate the importance of certain amphibian priority sites to a range of species as well as demonstrating that a wide range of partners who perhaps haven’t traditionally focused on amphibians are helping to make a difference to their survival. Again please feel free to add in as much or little details as appropriate for the scale of work you are involved in, an ASA team member will contact you for further information if needed. 3.4. Do you provide grants? Y/N 3.4.1. If so what grants do you currently offer and what is the approximate total amount per year? This information helps us understand how you are investing each year and helps us identify potential opportunities to fundraise together. 3.4.2. What additional capacity building investments do you currently make? Please define and include an approximate dollar value. Capacity building comes in a range of formats. By letting us know what you see as capacity building we will get a better sense of the communities priorities in this area and again learn more about how we can all work together to improve our approach to capacity building as an Alliance. 3.5. Describe any recent achievements (if any) that have helped further engagement, research and/or conservation directed towards amphibians and any additional details with regards to your choices above to help us get a clearer picture of what your institution does (or intends to do). The more information we can get on what you are already doing for amphibians the more effective we can be at helping you share your skills with other Alliance members and
finding partners to help you scale up your efforts. Once we learn more about your work a member of the ASA team will discuss with you how we can help promote your efforts through the Alliance network. 3.6. How could the Alliance assist you in your efforts to further protect amphibians? Please select all that apply: Please describe other ways in which you think that the Alliance could assist you: The more information we can get on your needs the more effectively we will be able to assist you in reaching your amphibian conservation goals. As the Alliance continues to grow we will be looking to Alliance members to help us better understand what tools we need to put in place to make the Alliance an effective force for amphibians 4.1. What actions would you like to see the Alliance act on as part of short, medium and long term strategy? Please provide as many examples as you feel necessary. If these are associated to the work of your organization and you feel able to help move the Alliance towards meeting these goals please let us know. 4.2. Can you recommend other organizations that should be invited to join the Alliance? We want the Alliance to be an open partnership if organizations passionate about making a difference for amphibians. If you know of any organizations that we should be having open discussions with regarding the Alliance and amphibian conservation please let us know.
ASA Partner Application Form version 1.1 last updated 14 August 2013
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