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                                Project Information Form

Working with its network of in-country partners, Inveneo delivers ICT solutions for
organizations that provide education, healthcare, relief, microfinance, economic
development and other essential services to underserved communities in the
developing world. We can design an ICT and power system to support your project
based on your goals, requirements, budget, local environment and other information
captured in this form.
Before you submit this form, here are some important things to know:

   Inveneo does NOT provide Internet access but our systems can connect to any
    available Internet service.
   Inveneo and our partners currently support projects in Sub-Saharan Africa, Nepal
    (new) and Bangladesh (new). For a list of specific countries, visit Inveneo's website.
    If your project is in a country were we do not currently operate, please contact us at
    mailto:info@inveneo.org before you submit this form.
   Inveneo doesn't provide grants or financing for projects. However, we can help you
    estimate the cost of a project for your fundraising efforts.
   Complete as much information as possible, but don’t worry if you don’t have
    answers for every question.
   For a list of things to consider in planning your ICT project, see Inveneo’s ICT
    Sustainability Primer.

After reviewing your form, Inveneo will either contact you directly regarding next steps
or we may forward your information to one or more of our in-country ICT partners
(ICIPs) for their review and follow up.

We look forward to working with you to extend life-changing ICTs to rural communities
around the world!




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Contact Information:
Organization Name:
Organization URL:
Organization Country
(Headquarters):
Contact Name:
Contact Phone:
Contact E-mail:


Project Type (check all that apply)
   Education                                                   Microfinance
   Healthcare                                                  Community Center/Internet
                                                               Café
  Refugee/Relief                                               Other:
Comments:




Brief Project Description:




Project Scope:
Country/countries
Is funding already
available?
Approximate
budget ($USD)
# of sites
Do facilities
already exist?


Location and type for each site (please include GPS coordinates, if available)
                               Location                                Type
Site 1:              E.g., Mangunde Mission,           E.g., Health clinic
                     Chibabava District,


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                     Mozambique (GPS
                     coordinates here)
Site 2:
Site 3:
Site 4:
Add more lines
here as needed

Environment Factors
Environment conditions for each site, including max temp and
                     Min.        Max.         Briefly describe the environment, including
                    Temp         temp        topography, vegetation (type, height), dust,
                                                             humidity, etc.
Site 1:
Site 2:
Site 3:
Site 4:
Add more lines
as needed


ICT Requirements:
 Please describe the ICT needs for each location at a high level:

 Example:
 Site #1: we would like to put computer learning centers in three secondary schools
 and connect the schools to each other and the Internet


                                Hours of operation      List other ICTs required – Examples:
Location          # Computers   per day (#)             printer, scanner, projector, server, etc.
Site #1
Site #2
Site #3
Site #4
Add more
lines here as
needed


Power Requirements:

              1) Is AC grid     2) Is wiring in       3) Average AC     4) Worst case outage
              power             good                  outage            duration in prior 6
              available?        condition?            duration?         months?
Site #1

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Site #2
Site #3
Site #4



Do you have any additional information that may affect the grid power such as a
pending rollout of grid power? Please explain by location below:

    -   Example: grid power will be installed in December 09




Software Requirements:

What desktop operating system to you want to use in your locations? (Choose one)
      Windows XP Home           _____ (available on most computers)
      Windows XP Professional _____ (additional fee applies)
      Linux                     _____
      I need advice             _____

If Linux, which version do you prefer?
        Ubuntu                     _____ (additional fees may apply)
        Xubuntu                    _____ (additional fees may apply)
        Other: ________________________________________________
        I need advice              _____

Do you require Open Office Suite? (Yes/no)


Comments:




What specific application or utility software need to run on the desktop computer
systems or server? Please specify required operating system.




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Examples:
    OpenMRS for health records (Linux)
    Microsoft Encarta for schools (Windows XP)



For schools: Learn Things Education Content (see www.inveneo.org for more info)
for Primary or Secondary Schools is designed for and deployed in 20+ African
countries (in English). Are you interested in having this curriculum pre-installed?
Yes____ /No_____



Technical Support:
 Does your organization have local technical support available for the project with
 skills in these areas?
 Basic IT administration: Yes____ /No_____
 Basic Computer networking: Yes____ /No___
 Linux Operating Systems: Yes____ /No_____ /Not Applicable____
 Microsoft Operating Systems: Yes____ /No_____ /Not Applicable____
 Open Source Software: Yes____ /No_____ /Not Applicable____
 Wireless (Wi-Fi) Network : Yes____ /No_____ /Not Applicable____

 Other comments:




Internet Services:
 If required, your organization will be responsible for acquiring Internet services.

 NOTE: if you need help, Inveneo or our local partner can advise you on your
 options

 Who will be the Internet Service Provider for your project?

 What type (e.g., DSL, GPRS, etc.) of Internet Service will be provided?

 Which site(s) will have this service?




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