AAA-Project 2015 (Short Title):
Name of Applicant / Organisation:

To the Head of the following Thematic Coordination Point (TCP) (NOTICE: Please choose the appropriate TCP!) on Agriculture & Ethnic Heritage (Coordination: Koprivnica Križevci) on Culture (Coordination: Styria) on Disaster prevention (Coordination: Carinthia) on Economy (Coordination: Vas) on Energy & Environment (Coordination: Međimurje) on Equal Opportunities (Coordination: Carinthia) on Europe (Coordination: Burgenland) on Healthcare (Coordination: Carinthia) on Higher Education (Coordination: Vas) on Inclusion (Coordination: Carinthia) on Mobility (Coordination: Burgenland) on Sports (Coordination: Styria) on Tourism (Coordination: Slovenia) of the Alps-Adriatic Alliance. Please send the project application to the responsible Thematic Coordination Point (TCP), which is responsible for pre-selection. You will find the address-list of all TCPs at the end of this document. After successful pre-selection the TCP will forward the application to the General Secretariat of the Alps-Adriatic-Alliance in Klagenfurt/Carinthia which also presides the Steering Committee:

TYPE OF APPLICATION:

PREPARATION COSTS FOR THE SUBMISSION OF A PROJECT WHICH IS TO BE CO-FINANCED FROM APPROPRIATE EU-PROGRAMS (the maximum amount from the joint budget is € 5.000,-- if approved by the Steering Committee)

JOINT PROJECT (the maximum amount from the joint budget is 20% of the overall project-costs or a maximum of € 4.000, -- if approved by the Steering Committee)

rEQUEST FOR PATRONAGE
(Patronages are supported with € 500,-- if approved by the Steering Committee and must involve at least two Alps-Adriatic-Alliance members.)

Title of project:

Short description of the project:

Duration of project:

from Klicken Sie hier, um ein Datum einzugeben. to Klicken Sie hier, um ein Datum einzugeben.

Name of Applicant /Organisation:

Project-partners within the 12 Alps-Adriatic-Alliance member regions:

(NOTICE: According to Point 5.2.1 of the Procedural Rules of the Alps-Adriatic-Alliance joint projects must involve at least three members from three countries as an absolute minimum! The number of Alps-Adriatic-Alliance-members involved in the project is an important selection criterion for every application!) Bundesland Burgenland (Austria) Istarska županija (Croatia) Karlovačka županija (Croatia) Bundesland Kärnten (Austria) Koprivničko-križevačka županija (Croatia) Krapinsko-zagorska županija (Croatia) Međimurska županija (Croatia) Republika Slovenija Bundesland Steiermark (Austria) Varaždinska županija (Croatia) Vas megye (Hungary) Virovitičko-podravska županija (Croatia)

1. Project Activities

Title of project:

Target group(s):

Expected number of participants:

Planned Activities:

Detailed Timetable:

Added Value of the project for the Alps-Adriatic-Alliance as a network: (NOTICE: According to Point 5.1.2. of the Procedural Rules the joint budget is intended to finance activities and projects which are significant for the entire network.)

2. Project Data

Applicant:
Name of Organisation/Institution:
Country / Region:
Street:
Postal Code/City:
Telephone/ Fax:	/
E-Mail:
Website:

Responsible contact person:
Name:
Function:
Country:
Region:
Street:
Postal Code/City:
Telephone/ Fax:	/
E-Mail:

Description of the applicant organisation:

Project Partners

(Notice: According to Point 5.2.1. of the Procedural Rules a joint project must involve at least three members from three countries of the Alps-Adriatic-Alliance as an absolute minimum!) So the partners 1 and 2 have to be within the AAA member regions!

Partner 1: within the 12 Alps-Adriatic-Alliance member regions from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 2: within the 12 Alps-Adriatic-Alliance member regions from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 3: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 4: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 5: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 6: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 7: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 8: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 9: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 10: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

Partner 11: ☐ within the 12 Alps-Adriatic-Alliance member regions ☐ from other regions
Name of Organisation / Institution:
Street:
Postal Code/City:
Country / Region:
Contact person:
Telephone/Fax:	/
E-Mail:
Website:

3. Financing of the Project

Cost Schedule:

Detailed listing of Overall-Costs:	EURO
Total costs:
Detailed list of funding from public sources:
Deduction of other funding sources: (Sponsors, registration fees, etc.):
Amount requested from the joint budget of the Alps-Adriatic-Alliance:

The funding requested from the joint budget will be used for the following purposes:
NOTICE: After completion of the project, the original receipts have to be submitted to the General Secretariat by mail. The receipts have to be in absolute accordance with the purposes mentioned above!!!

Recipient of the amount granted from the joint budget:
Name of Organisation/Institution:
Street:
Postal Code/City:
Country:
Region:
Responsible contact person:
Name:
Function:
Telephone/Fax:
E-Mail and Website:
Banking Information:
IBAN:
BIC:

I confirm that I have filled out this form truthfully and complete. After completion of the project I agree to send a detailed report, a report on the expenditure of funds and the original receipts to the General Secretariat, in accordance with Point 5.2.5. of the Procedural Rules of the Alps-Adriatic-Alliance. The General Secretariat and the Steering Committee have the right to carry out checks on the appropriate use of financial resources at any time. If irregularities should be found, the resources made available have to be repaid to the joint budget of the Alps-Adriatic-Alliance. If the approved project is not carried out in absolute accordance with the facts described above (e.g. name of project is changed, listed partners don´t participate) the General Secretariat in accordance with the TCP concerned, has the right to deduct 50% from the amount granted by the Steering Committee. I furthermore agree to use the logo of the Alps-Adriatic-Alliance on all project-related publications (posters, flyers, websites etc.). The logo is available at the General Secretariat (e-mail: abt1.alpeadria@ktn.gv.at). I agree that the bodies of the Alps-Adriatic-Alliance may use the submitted project for media-purposes.

, Klicken Sie hier, um ein Datum einzugeben.

……………………………………….	…………………………………………………………….

Place, date	Name of applicant (E-Mail-Version)
Stamp, Signature of applicant (printed version)

4. To be filled in by the responsible TCP

Please state why this project should be supported:

, Klicken Sie hier, um ein Datum einzugeben.

……………………………………….	…………………………………………………………….

Place, date	Name of the Chairperson of the TCO (E-Mail-Version)
Stamp, Signature of the Chairperson (printed version)

5. To be filled in by the Chairman of the Steering Committee General Secretariat of the Alps-Adriatic-Alliance/ Alps-Adriatic-Alliance Contact Point Carinthia Mag. Thomas Pseiner Amt der Kärntner Landesregierung/Regional Government of Carinthia Mießtaler Straße1 A-9020 KLAGENFURT AM WÖRTHERSEE Tel.: +43(0)5 0536-10134 / Fax: +43(0)5 0536-10130 E-mail: thomas.pseiner@ktn.gv.at abt1.alpeadria@ktn.gv.at

In its meeting on ………………….. in ………………………….the Steering Committee of the Alps-Adriatic-Alliance

approved	rejected

the project.

Reasons for rejection:

……………………………………….	…………………………………………………………….

Place, date	Name, Stamp, Signature of the Chairperson
of the Steering Committee

Alps-Adriatic-Alliance Thematic Coordination Points (TCPs)

TCP on Agriculture & Ethnic Heritage Coordinated by Koprivnica-Križevci County: M.S. Vladimir Šadek Head of Section for International Cooperation and European funds Nemčićeva 5 HR-48000 KOPRIVNICA Tel.: + 38 548 658 120 Fax: + 38 548 622 131 E-Mail: vladimir.sadek@kckzz.hr	TCP on Culture Coordinated by Styria: Sandra Kocuvan Amt der Steiermärkischen Landesregierung Abteilung 9 Kultur, Europa, Außenbeziehungen Referat Beteiligungen und Kultur International Landhausgasse 7 A-8010 GRAZ Tel.: + 43 316 877-3161 Fax: + 43 316 877-3156 E-Mail: sandra.kocuvan@stmk.gv.at www.kultur.steiermark.at/alpen-adria-allianz
TCP on Disaster prevention Coordinated by Carinthia: The coordinator of this TCP will be nominated in April 2015.	TCP on Economy Coordinated by Vas: Chairman Dr. János Kondor Confederation of Employers and Industrialists of County Vas Kossuth L. Str. 6 H-9700 SZOMBATHELY Tel.: + 36 94 511-440 Fax: + 36 94 511-441 E-Mail: vmgysz@gmail.com Coordination Zoltán Farsang Head of the Office National Regional Creative Institute Berzsenyi Square 2 H-9700 SZOMBATHELY Tel: +36 94 519-688 E-mail:kreativ@pszk.nyme.hu Please contact BOTH gentlemen when addressing the TCP!
TCP on Energy & Environment Coordinated by Međimurje County: Dir. Mario Klobučarić MENEA – Medjimurje Energetic Agency Bana Josipa Jelačića 22 HR-40 000 ČAKOVEC Tel.: + 38 540 395 560 Fax: + 38 540 395 142 E-mail: mario.klobucaric@menea.hr www.menea.hr	TCP on Equal Opportunities Coordinated by Carinthia: Mag. Dr. Michaela Slamanig Referat für Frauen und Gleichbehandlung Amt der Kärntner Landesregierung Mießtaler Straße 1 A-9020 KLAGENFURT AM WÖRTHERSEE Tel.: + 43 50536-14822 Fax: + 43 50536-14820 E-Mail: michaela.slamanig@ktn.gv.at

TCP Europe Coordinated by Burgenland: WHRin Prof.in(FH) Mag.a Ingrid Schwab-Matkovits Amt der Burgenländischen Landesregierung Landesamtsdirektion Stabsstelle Europabüro und Statistik Europaplatz 1 A-7000 EISENSTADT Tel.: + 43 57600-2826 Fax: + 43 57600-2927 E-Mail: post.europabuero@bgld.gv.at	TCP on Healthcare Coordinated by Carinthia: Mag. Karl Wulz (general manager) MMag. Kathrin Brugger (deputy general manager) Sanicademia – International Training Academy for Health Professionals EEIG Nikolaigasse 43, A-9500 VILLACH Tel.: + 43 4242/22400, Fax: + 43 4242/208-1979 E-Mail: info@sanicademia.eu MMag. Dr. Verena Hofer Amt der Kärntner Landesregierung Abteilung 5 – Gesundheit Mießtaler Straße 1 A-9020 KLAGENFURT AM WÖRTHERSEE Tel.: + 43 50536-15011 Mobil: +43 664 80536 15011 Fax: + 43 50536-15000 E-Mail: verena.hofer@ktn.gv.at
TCP Higher Education Coordinated by Vas: Dr. Henriette Dancs, PhD Dozent Head Coordinator of the International Network of Sport and Health Science CEO SportProfNet University of West Hungary, Institute of Sport Science Károlyi G. Square 4, H-9700 SZOMBATHELY Tel.: +36 30 4353-800 E-Mail: dancs@mnsk.nyme.hu	TCP on Inclusion Coordinated by Carinthian NGO: Mag. Dr. Dieter Klammer Verein INCLUSIA, Menschen – wie wir sind St. Anna Str. 23 A-9081 REIFNITZ AM WÖRTHERSEE Tel: + 43 4273 - 21017, Mobile: + 43 664 - 7382 7132 E-Mail: info@inclusia.at
TCP on Mobility Coordinated by Burgenland: Mag. Peter Zinggl, LL.M. Amt der Burgenländischen Landesregierung Stabsstelle Raumordnung und Wohnbauförderung Europaplatz 1, A-7000 EISENSTADT Tel.: + 43 57600-2670 Fax: + 43 57600-2055 E-Mail: post.ro@bgld.gv.at
TCP on Sports Coordinated by Styria: Mag. Thomas Hirschböck Amt der Steiermärkischen Landesregierung Abteilung 12 Wirtschaft, Tourismus, Sport Referat Sport Jahngasse 1, A-8010 GRAZ Tel.: + 43 316 877-5566 Fax: + 43 316 877-3456 E-Mail: thomas.hirschboeck@stmk.gv.at sport@stmk.gv.at	TCP on Tourism Coordinated by Skupnost Občin Slovenije: Saša KEK Skupnost Občin Slovenije Association of Municipalities and towns of Slovenia Partizanska 1, SI-2000 MARIBOR Tel.: + 38 62234 15 00 Fax: +38 62234 15 03 Mail: sasa.kek@skupnostobcin.si