Council For Non-Governmental Organization In Malawi

MEMBERSHIP FORM


Council for Non Governmental Organisations in Malawi
PO Box 480, Blantyre, Malawi
Tel/fax:01- 676 409/ 459
E-mail: congoma@malawi.net

NGO NAME :	____________________________________
NGO INITIALS/ACRONYM, if used	____________________________________
NGO HQ ADDRESS	____________________________________
	____________________________________
	____________________________________
DATE FORMED	____________________________________
DATE APPROVED BY GOM	____________________________________
CHAIRPERSON NAME	____________________________________
PHONE	____________________________________
ADDRESS	____________________________________
	____________________________________
HEAD OF SECRETARIAT’S NAME	____________________________________
PHONE	____________________________________
FAX	____________________________________

STATEMENT

I hereby apply for membership of CONGOMA, which is the designated co-ordinating body for Non Governmental Organisations in Malawi. I understand that if accepted we will be notified of the relevant Membership Fee.

I pledge that the Organisation of which I am Chairperson will uphold the honour and integrity of the NGO community in Malawi and Further the Development of the people of Malawi.


_______________________	_______________________	_______________________
Signed	Chairperson	Date

Please submit this application form to the above address together with the other registration requirements for either Malawian or International NGOs, whichever applies to you.