Contest for EU award for investigative journalism Serbia/2017 Form A – Presentation of the nominated story and the journalist Title of the investigative story: Name of the investigative journalist(s) and date of birth (to be provided for the lead author and any co-authors) Date of publication/broadcast: Media in which the investigative story was published: 1. Describe your entry in 500 words or less outlining: a. Relevance of the issue/topic/sector addressed in the investigative story for the people or country: b. Main qualities of the entry: c. Originality aspects of the entry: d. Impact of the story (e.g. follow up actions taken by responsible persons or investigated actors): 2. Present the journalist and his/her qualities: (max 500 words) This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of The Peace Institute and Novi Sad school of journalism and can under no circumstances be regarded as reflecting the position of the European Union. 3. Obligatory attachment: investigative story and when applicable, its translation. Please provide URL or attach PDF according to submission instructions. 4. Additional information: Do not send any additional materials at the application stage. Please note, that the award candidates/nominators may be contacted for additional information and/or materials in assessment phase and prompt submission is expected. Name: E-mail: Phone number: This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of The Peace Institute and Novi Sad school of journalism and can under no circumstances be regarded as reflecting the position of the European Union. Contest for EU award for investigative journalism Serbia/2017 Form B – Declaration by the journalist and nominator Name of the journalist (author): Name of co-author(s), if applicable: Name of the nominator (if different than author): Address of the (self) nominator: Contact person of the (self) nominator: E-mail address of the (self) nominator: Phone of the (self) nominator: Declaration by the journalist/author: I, >Name of the journalist/author>, hereby declare that - I give consent to the nominator to nominate me for the EU award for investigative journalism (if applicable), - I affirm that I am the author of the work being nominated, - The information provided in the entry is correct, - I agree with and accept the rules of the contest, - I am not in any of the situations listed Section 2.3.3 of the Practical Guide to contract procedures for EU external actions (available from the following Internet address: http://ec.europa.eu/europeaid/prag/document.do?chapterId=2.3.3.&id=221) In case of receiving the award, This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of The Peace Institute and Novi Sad school of journalism and can under no circumstances be regarded as reflecting the position of the European Union. - I accept publicity obligations, such as publicising information on the award and taking part in one of the post-award events (e.g. lecture, speech, round table); - I accept eventual checks and audits by the Commission, OLAF and the Court of Auditors; Place and date: Signature of the (lead) author: This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of The Peace Institute and Novi Sad school of journalism and can under no circumstances be regarded as reflecting the position of the European Union. Declaration by the nominator: > name of the nominator<, represented by >name of the legal representative< (if applicable) hereby declare that - The information provided in the entry is correct - I agree with and accept the rules of the contest. Place and date: Signature the nominator: This document has been produced with the financial assistance of the European Union. The contents of this document are the sole responsibility of The Peace Institute and Novi Sad school of journalism and can under no circumstances be regarded as reflecting the position of the European Union.
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