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Name of Association *
Abbreviation (If any)
Present Physical Address *
Postal Address *
Telephone *
Fax *
Email *
Certificate of Registration No. *
Date of registration *
Give brief description of the Association *

Full List of the Association Leadership:

a. Chairperson *
b. Vice Chairperson *
c. Treasure *
c. Executive Secretary / CEO *
d. Council Members *

Associationís Members:

a. Number of Active Members *
b. Number of Inactive Members *
Type of Membership applied for: *

Required Membership Documents:

a. Copies of the Registration Certificate *
b. Constitution of Association *
*
Date *
Name *


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