TF IGP Basic Information (Sample)

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The Toyota Foundation 2017 International Grant Program

Cultivating empathy through learning from our Neighbors: Practitioners exchange for common issues in Asia
Basic Information Entry Form
1. Fill in all fields. If not applicable, please fill in N/A.
2. Check the sample sample form.
3. Do not change the format.

C. Open Field
Thematic Area
(Select from the drop-down list) Please specify your theme in a few words here if you chose "C. Open Field"
e.g. "Poverty Alleviation", "Children's Education", "Women's Empowerment", etc. Otherwise please fill in N/A.
Period Period
Budget (JPY) 765 0,000 (1 yr/2yrs) (Select 1 yr/2yrs)
2 yr(s)

Target Country/Area 3 or more


Country/Area 1 Country/Area 2
Countries/Areas (Enter N/A or list the countries/areas)
(Select from the drop-down list) Taiwan Japan Vietnam

Project title
(Please put your project title)
(Max. 25 words)

Project outline
(Please put your project title)
(Max. 200 words )

Information on Representative

Name of Representative
(First name, Family name)
Chou Chiahao

Gender
Male Country of Residence Taiwan Age 56 Nationality Taiwanese
(Female/Male)
Have you, or principal project members, previously If yes, please specify the grantee
received grants from the Toyota Foundation? NO otherwise fill N/A
N/A

Phone number Date of birth


886-XXXXXXX Month 10 Date 15 Year 1974
(Start from country code) (Use Number)

Postal code 10XXX E-mail address [email protected]

Postal address XXXX, Taipei, Taiwan

Title/Position Executive Director

Affiliation G
Website
www.GNGO.org.tw
(Fill in N/A if not applicable)

Information on Contact Person


If the Representative also takes a role as Contact Person, please choose "YES" from the
Will the Representative also drop-down list in the left cell. All information below automatically filled.
serve as Contact Person? YES If not, please choose "NO" and fill in all blanks. You can delete or overwrite the all
formulas and instructions below.

Contact Person
Chou Chiahao
(First name and Family name)

Phone number
886-XXXXXXX
(Start from country code)

Gender (Female/Male) Male Country of Residence Taiwan Age 56 Nationality Taiwanese

Postal code 10XXX E-mail address [email protected]

Postal address XXXX, Taipei, Taiwan


Title/Position Executive Director
Affiliation G

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