Membership Application Form

Name of Organization
Is this a membership organization ?
YESNO
Registered in which countries
Please tick areas of work that your organization focuses on
Domestic ViolenceLegal Aid and Paralegal SupportLiteracy And NumeracyFGMEconomic EmpowermentReproductive RightsTraditional, Cultural & Customary LawEarly/ Child/ Forced MarriagesSelf Help GroupsPeace building and Conflict ResolutionOthers (Please list)
Year Founded
Email
Telephone
Website
Physical & Postal Address
Contact Persons (Provide three names; we need to have alternatives, if unable to reach your primary contact)
Vision Statement
Mission Statement
State current programs that your organization is working on (Please list them below)
Does your organization have any recent publications, (Please list them below)
Please elaborate the relevance of your organization’s work to SIHA Network
Please state your expectations for becoming a SIHA member and why you want to become a member of SIHA