Fillable Printable Application Form for Non-Governmental Organization
Fillable Printable Application Form for Non-Governmental Organization
Application Form for Non-Governmental Organization
APPLICATION FORM FOR NON-GOVERNMENTAL ORGANIZATIONS
(Please read each question carefully and mark the appropriate box or fill out the blank spaces in either English or French.)
HANDWRITTEN OR ALTERED FORMS WILL NOT BE ACCEPTED
1
Organization’s General Information
Name of Organization Year Founded (inc. Month)
Country or countries where the NGO is registered as a non-profit and tax-exempt organization. (Please indicate
the year of registration in parenthesis, next to the country.)
Headquarters’ mailing address
Telephone (please include country and area codes) FAX (please include country and area codes)
E-mail address Web address
Will your organization have a representative at the United Nations? Yes No
President or Chief Administrative Officer
Name Last name
Address Telephone E-mail Address
Main Representative at the United Nations
Name Last name
Address Telephone E-mail Address
2
Representatives’ Information
Page 1 / 3
3
Areas of Interest
4
Organization’s Detailed Information
What is the scope of your organization (check one)?
Local National International
How many registered members does your organization have?
Are you already accredited with any intergovernmental organization? Yes (please indicate name) No
What is your most recent annual budget? (In US Dollars)
Ageing Environment _ International Peace and Security
Agriculture Family _ Population
Atomic Energy Food _ Poverty Issues
Education Migration
Energy Outer Space
Biodiversity Governance Refugees
Children Health Religion, Freedom of Beliefs
Climate Change HIV/AIDS Science and Technology
Conflict Resolution Human Rights Social Development
Crime Prevention Human Settlements Sustainable Development
Criminal Justice Humanitarian Affairs Technical Cooperation
Culture Indigenous Peoples Trade, Finance and Market
Development International Law United Nations Associations
Disabled Persons Labour Water
Disarmament Least Developed Countries Women
Drug Control Media and Communications Youth
Page 2 / 3
5
Organization’s Activities
Which of the following are the main sources of funding for your organization’s activities?
Over the last year, has your NGO organized any activities related to the United Nations? Yes (indicate) No
Activities (Conferences,
Seminars, etc.)
Subject(s)
Date(s)
Number of
Participants
Please provide details about UN-related newsletters, magazines, website, etc. issued regularly by your organization.
Please attach copies (for web-related content, provide a direct link to the information)
Title
Frequency
Circulation / print run
References: List four organizations who are familiar with your organization and its work (UN agencies and
organizations can be included)
Name
Contact information (full address, telephone, fax, e-mail)
Name of President or Chief Administrative Officer (completing this form)Date
Signature of President or Chief Administrative Officer and Stamp
Other (please specify)
Fund-raising activities Membership fees Voluntary contributions
Government subsidies Non-governmental donations Sales of publications/other materials
Page 3 / 3
