(Since this form requires a signature, (as indicated below), please print and fax
completed form to the GEF Secretariat:- Hemanta Mishra, Fax (202) 522-3240/45)
Name of Organization: ......................................................................
Date Established: ...................................................................
Address of Principal Office: ...............................................................
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Telephone/Fax ...................................................................
Email ...................................................................
Purpose of Organization ...................................................................
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Country/(ies) in which organization is active ..............................................
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Particular areas of the GEF to which organization's competence and relevance pertains.
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Information on programs and activities of organization in areas that are relevant to the GEF and country/ies in which they are carried out.
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Members of governing body of organization and their country of nationality.
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In respect of membership organizations: -Description of membership, indicating total numbers and their geographical distribution
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Please attach copies of Annual Reports and Financial Statements
Name and signature of CEO/Senior Official of NGO
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................................................................................................ (please print and sign)
Please attach additional sheets if required.