Application Form 2017 (version 02)Website: www.theonerotary3450.org email: info@rotary3450.org

Nomination Form 2016This Award is intended to recognize an individual whose extraordinary service activities exemplify the Rotary ideal of Service Above Self. THE AWARD The winner of THE ONE 2017 will receive US$100,000

that will go towards the winner’s humanitarian efforts. The two runners-ups will each receive US$50,000 that

will go towards their humanitarian efforts. The Rotary Club that nominates the winner will

receive US$5,000 to support their service projects.CRITERIA Candidates must have provided outstanding and

remarkable services to mankind; Candidates must have demonstrated daily dedication

and continued devotion to humanitarian efforts; and Candidates must have promoted integrity and

advanced world understanding, goodwill and peace through their humanitarian efforts.

ELIGIBILITY Candidates must be an individual aged 18 or above. There is

no limitation as to sex, race and nationality. Candidates cannot be *Rotarians, employees of a club,

district or other Rotary entity or of Rotary International. Spouses, lineal descendants, and ancestors of persons in the foregoing categories are also ineligible. * This rule also applies for any Ex-Rotarian who has left Rotary for less than three years.

The award will not be presented posthumously. Any candidate previously awarded a cash prize by THE ONE

organising committee will not be eligible to apply again; all others are welcome to apply more than once.

RESPONSIBILITIES OF CANDIDATES, FINALISTS AND WINNER THE ONE organising committee reserves the right to use all

materials submitted by candidates including photos and videos for promotional materials.

The 3 finalists (including the winner) are required to attend THE ONE Award Gala Dinner in May 16, 2017 in Hong Kong and should be responsible for their own personal health and wellbeing during their whole visit to Hong Kong and back.

The 3 finalists (including the winner) must be available for promotion and interviews. They are responsible to keep THE

ONE award organising committee updated as required. THE ONE award organising committee reserves the right to

request interviews of the 3 finalists (including the winner) and to use the interviews or their contents in whole or in part as promotional materials.

Any materials taken by THE ONE with any or all of the finalists (including the winner) including interviews, photographs and videos etc, remains the exclusive property of THE ONE

The winner of THE ONE will act as a spokesperson for THE ONE, and may not represent any other award during their year of tenure as THE ONE winner.

THE ONE Committee reserves all right to the following conditions:- Any candidate nominated for THE ONE can be removed

from consideration for THE ONE if there is any misconduct or wrongdoing or scandal associated with his/her charity

- The spokesperson must demonstrate integrity and exemplify as a role model to others in the community. THE ONE reserves the right to suspend or terminate his/her role as a spokesperson for THE ONE, if the winner fails to maintain good standing during his/her term.

For award prize release procedures, please observe the guidelines on THE ONE website.

RESPONSIBILITIES OF ENDORSING ROTARY CLUB The Endorsing Rotary Club should be responsible to ensure

that all the contents submitted for their nomination is true and correct.

The Endorsing Rotary Club should read the nomination documents carefully and ensure the candidate and the nominator have a full understanding on the award criteria, eligibility and responsibilities of being a Candidate, an Award Recipient and a Finalist.

The Endorsing Rotary Club will act as the liaison party between THE ONE (Int’l) and the Candidate, and assist if any communication problem occurs.

If his/her Candidate becomes a Finalist of THE ONE (Int’l), the Endorsing Rotary Club should also assist their Nominee to complete the proposal and reports as required by the stewardship sub-committee.

The Endorsing Rotary Club has the duty and obligation to oversee and ensure that the prize money given by THE ONE (Int’l) to the Winner and Finalists is used in accordance with the approval given by us. The Endorsing Rotary Club’s duty is to ensure that due diligence is carried out.

NOMINATION GUIDELINES Each Rotary Club is eligible to nominate more than one

candidate. A complete nomination will include the nomination

form, a CV or resume and a “Humanity Service Description Form” (to be downloaded from THE ONE website), candidate’s passport/ traveling document or ID copy and a digital or print photograph of the candidate.

All nominations must be endorsed by a Rotary Club. Nominations must include the specified ‘Humanity Service

Description Form’ that highlights the following points. Answers for the following questions should be limited to 1,000 words: How does the candidate give totally to the cause every day? How does the candidate dedicate to the improvement of mankind? How does his/her work advocate to humanity? How does he/she work for the highest standard of good? How did he/she promote integrity and advanced world

understanding, goodwill, and peace through his/her humanitarian efforts?

Supplementary documentation or material is highly desirable. (i.e. 1-2 video clips, 10-15 photos in service and a few links to articles, financial Statement/audited financial reports in the past two years etc.) Semi-finalists and Finalists will all be required to submit supplementary documentation.

For written supplementary information, please limit to five pages only.

All nomination forms that are submitted by email should be submitted in a word document format or PDF. All photo materials that are submitted online should be submitted as a JPEG or TIF of no less than 1MB.

Electronic submissions are highly encouraged. THE ONE Organising Committee reserves the right to verify a

candidate's service achievements through all means including the references submitted by the candidate.

The decision of THE ONE organising committee and Rotary International District 3450 shall be final and conclusive on all matters related to the nomination.

Should there be any discrepancy between or dispute arising from the English and any other language versions of these nomination guidelines, the English version shall apply and prevail.

Failure to comply with the nomination guidelines can result in penalisation of the candidate.

DEADLINE Completed nomination forms with all supporting documents

should be sent to THE ONE, a project by Rotary District 3450 Organising Committee, Rotary Information Centre, 14/F Capital Commercial Building, 26 Leighton Road, Causeway Bay, Hong Kong or email to nominations@theonerotary3450.org

Please fill in English.

Application Form 2017 (version 02)www.theonerotary3450.org

by 31 st December 2016. Late or incomplete nomination forms will not be considered

Please fill in English.

Application Form 2017 (version 02)www.theonerotary3450.org

SCHEDULEJuly 1, 2016 Nomination StartsDec 31, 2016 Nomination Documents Submission DueJan-Apr, 2017 Selection ProcessMay16, 2017 Award Gala Dinner (Winner Announcement)

A complete application will include: Nomination form signed by the candidate, the nominator and

the current president of the endorsing Rotary Club or a representative of the approved organisation (sections: A, B1, B2 & D)

Contact information of two References (section: C) Candidate’s Passport / Traveling Document copy Resume of the candidate A completed Humanity Service Description Form A digital or print photograph of the candidate (> 1MB) Supplementary documents

A. TO BE COMPLETED BY THE CANDIDATECandidate Personal DetailsName of Candidate: ____________________________□ Male □ Female Date of Birth: __________________Traveling Document No/ Issuing Country: _____________Address:_______________________________________ __________________________________________________________________________________________City:__________________________________________ State/Province, Postal Code, Country :________________ Telephone:_________________ Fax:________________Email:________________________________________

Candidate Other Information1. Candidate’s profession or vocation:______________

_________________________________________2. Candidate’s current position or title: _____________

__________________________________________

3. Professional awards or Honours (if applicable): ________________________________________________

B1. TO BE COMPLETED BY NOMINATORNominator InformationNominator’s Name:_______________________ (Please Print)Address:_________________________________________

________________________________________________________________________________________________City:_____________________________________________ State/Province, Postal Code, Country :__________________ Telephone:_____________ Fax:_____________________Email:___________________________________________

Duration of acquaintance with the candidate: ________Year(s)

On a separate “Humanity Service Description Form” attached to describe the candidate’s humanitarian service activities, the impact of these activities on you and the community, how these activities have changed lives for the better and why this candidate should be considered for this award (not more than 1000 words in English).I hereby declare that the information in this nomination form is true to the best of my knowledge.

_____________________ ______________________Nominator’s Signature Date

B2. TO BE COMPLETED BY ENDORSING ROTARY CLUB

Endorsing Rotary Club: _____________________________________ _________________________District (if applicable): _____________Rotary Club President: _______________________________________________ (Please Print)Email: __________________________ Telephone:_________________

____________________ ________________________Club President’s Signature DateC. REFERENCE INFORMATION

Name of 1st Reference:________________________(Please Print)Title/Position:_______________________________________________ Organization:______________________________________________ Telephone:_______________ Fax:__________________Email:__________________________________________Duration of acquaintance with the candidate: _____Year(s)

Name of 2nd Reference:_______________________(Please Print)Title/Position:_______________________________________________ Organisation:______________________________________________ Telephone:_______________ Fax:__________________Email:__________________________________________Duration of acquaintance with the candidate: _____Year(s)

D. DECLARATION BY CANDIDATEI attest to all the facts in this nomination form and give permission for their publication related to the program. I hereby declare that I agree to the selection rules of THE ONE set out by RI District 3450 and the judging panel

Please fill in English.

Application Form 2017 (version 02)www.theonerotary3450.org

which are final and binding in all aspects relating to the Award. I am prepared to attend interviews as and when necessary. If I am selected as one of the four finalists, I will attend the THE ONE Award Gala Dinner in May16, 2017 and all media activities arranged by the organisers. I will also participate in the events related to the promotion of humanitarian spirit thereafter.

__________________ ___________________Candidate’s Signature Date

* Any changes to the original script of THE ONE nomination form may result in the application being nullified.