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National Intelligence Platform and the 333 National Telehealth Service, Bangladesh

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Alliance Application Form

Submit an Expression of Interest and/or Demand Signal. UNOSSC reviews submissions on a rolling basis.

1. Official name of organization / institution / government entity (exclusions to apply) *
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2. Country *
3. Region *
4. SDG *
5. Partner category *
6. Website *
7. Brief description of your institution (max. 150 words) *
Name for the Lead *
Title for the Lead *
Email address for the Lead *
Name for the co-lead
Title for the co-lead
Email address for the co-lead
Section 3. Expression of Interest in the Alliance *
Additional information on proposed areas of engagement may be requested through the platform following initial review by the Alliance Secretariat.
Section 4. Due Diligence and Integrity Declaration *

Submission Note:

  • Submission of this Expression of Interest form does not automatically confer participation in the Alliance.
  • All submissions will be reviewed by the Alliance Secretariat, including basic eligibility screening and proportionate due diligence, as appropriate.
  • Participation in Alliance activities is determined based on relevance to articulated cooperation needs, alignment with Alliance principles, and integrity considerations.
  • Engagement under the Alliance is voluntary, non-binding, and facilitative in nature, and does not constitute funding approval, contractual commitment, or institutional membership.
  • The Alliance Secretariat may contact submitting entities for additional information or clarification during the review process.

Submission of Demand Form

Description of Demand

Indicate the type of support or cooperation requested through the Alliance.
Please briefly describe the challenge, gap, or priority. (Max. 300 words)

Thematic and Geographic Focus

Please indicate the main focus areas of your demand:

A. Thematic Areas (select up to three)
B. Geographic Focus (select all that apply)

Proposed Engagement Modalities

Please indicate how you would like to engage through the Alliance (select all that apply):

Expected Outcomes

Please indicate the main results you seek to achieve through this engagement. (Max. 200 words)
Examples:
• Capacity strengthened
• Partnerships established
• Sectoral or regional strategies co-developed
• Solutions piloted
• Knowledge generated
• Policies informed

Timeline and Readiness (if applicable)

1. Expected timeframe for engagement:
2. Current stage:

Additional Information

Please provide any additional information, documents, or links relevant to this submission.
(Max. 200 words or upload link)

Submission of Offer Form

Description of Contribution

Indicate the type of contribution your institution can provide and describe the expertise, resources, or solutions you may offer.
Please briefly describe your proposed contribution. (Max. 300 words)

Thematic and Geographic Focus

Please indicate the main focus areas of your interest:

A. Thematic Areas (select up to three)
B. Geographic Focus (select all that apply)

Proposed Engagement Modalities

Please indicate how you would like to engage through the Alliance (select all that apply):

Expected Outcomes

Please indicate the main results you aim to achieve through this engagement. (Max. 200 words)
Examples:
• Capacity strengthened
• Partnerships established
• Sectoral or regional strategies co-developed
• Solutions piloted
• Knowledge generated
• Policies informed

Timeline and Readiness (if applicable)

1. Expected timeframe for engagement:
2. Current stage:

Additional Information

Please provide any additional information, documents, or links relevant to this submission.
(Max. 200 words or upload link)

Organization Registration

Authentication & Due Diligence This prototype simulates identity verification, due diligence confirmation, and an authentication step before submission. *
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Email address *
Password *
Confirm Password *
Name of institution / organization *
Country / Region *
Organization Type *
Organization other *
Function / role *
Organization logo *
Maximum file size: 1 GB

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