NGO WELFARE TRUST

 APPLICATION FORM 

To

SNEH 

TRUSTEE

NGO WELFARE TRUST

sector NI/ 206 ALIGANJ

LUCKNOW.

Dear Sir,

We hereby apply as member OF NGO WELFARE TRUSTas per the following details:-

1.      Name of the Organization:   ___________________________________________

2.      Address: __________________________________________________________

__________________________________________________________________

Tel. No.________________________   Fax No._________________________

Mobile No. __________________________________

Email___________________________________________________________

3.      Status of the Organization (Society/Trust/25B Company) ___________________

4.      Date of Registration: __________________Regn. No._____________________

5.      Major Activities: ___________________________________________________

__________________________________________________________________

          (Attach separate sheets, if necessary)

6.      Geographical territories where major activities undertaken : _________________

__________________________________________________________________

7.      Income & Expenditure during last financial year:  Income        Rs._________ lakhs

                                                                                    Expenditure Rs. ________ lakhs

8.      No. of employees : Full time______ Part time ______ Volunteers _______

NGO WELFARE TRUST

9.  Contact Person:

Name_____________________________________________________________

      S/o, D/o, W/o _______ ________ ________ ______ ______ _____ _____ ____ __

Designation________________________________________________________

Address___________________________________________________________

__________________________________________________________________

Tel. Nos._____________________    Fax No.____________________________

      E-mail: ____________________________________________________________

DECLARATION

We hereby confirm that

i.                    The information provided herein above is true and correct to the best of my/our                                 knowledge and belief.

ii.                  We undertake that we shall abide by the Rules and Regulations of NGO WELFARE TRUST

iii.                Our organization is not black-listed by Government or any other organization.

We are aware that

i.                    NGO WELFARE TRUSTis playing a role of ‘facilitator’ between us and funding organizations.

ii.                  NGO WELFARE TRUSTdo not promise or guarantee funding.

iii.                Application only does not entitle membership status to us.

We attach the following :-

i)                    Self Certified copy of the Registration/Renewal Certificate.

ii)                  Self Certified List of present Office Bearers

iii)                Curriculum Vitae of the Contact Person and the Passport size photograph.

iv)                Certified copy of the audited accounts of the last 3 years.

v)                  Demand Draft No. ___________ for Rs. 1500 in favour of NGO WELFARE TRUSTtowards Registration Fee.

Place:                                                                         Signature ___________________

Date :                                                                          Name _____________________

                                                                                    Seal of the Organization