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Untitled Untitled To join membership, please complete the membership application form (English, French, and Spanish) and send to: This e-mail address is being protected from spambots, you need JavaScript enabled to view it


Transaction Type: New Membership Membership Renewal
First Name: *
Last Name: *
Job Title: *
Organisation Name: *
Postal Address: *
City: *
Country *
Telephone: *
Fax: *
Email: *
Name on Your Credit Card *
Website:
Organisation description: *

* REQUIRED FIELD
How did you hear about CIVICUS?
e-CIVICUS bulletin
Referral from a CIVICUS Member
Civil Society Watch newsletter
Meeting with a member of CIVICUS staff
CIVICUS website
Other:

MEMBERSHIP CATEGORIES & PAYABLE AMOUNT
For further information on categories, please see our Membership policy - enclosed or available from the membership section of our website at www.civicus.org

Citizen Organisation (Select from Group 1-6)
Annual income in US$ or Euros€

Group 1 - up to $75,000 / € 60,000

$50 / €40
Group 2 - $75,001 to $250,000 / €60,001 to €200,000

$75 / €60
Group 3 - $250,001 to $500,000 / €200,001 to €400,000

$125 / €105
Group 4 - $500,001 to $1,000,000 / €400,001 to €800,000

$200 / €165
Group 5 - $1,000,001 to $3,000,000 / €800,001 to €2,500,000

$300 / €250
Group 6 - $3,000,001 and over / €2,500,001 and over

$500 / €410


Grant-making Organisation
Fee required is 0.1% of the organisation's annual grants. (Minimum Amount $500 / €410 and Maximum Amount
$10,000 / €8,235).


Corporate Member $500 / €410


Individual Member
From a developing country $50 / €40
From a developed country $100 / €80


Youth Member (16-24)
From a developing country $15 / €10
From a developed country $25 / €20

Please prioritise your top 3 areas of interest by writing 1 to 3 next to the sectors below (1=highest priority).
Civil Society Strengthening/Support
Democracy & Governance
Human Rights & Legal Issues
Health
Culture & Recreation
Education & Research
Environment
General Charitable Purposes
Housing & Homelessness
International Development
Community Development
Professional Association/Union
Economic Development
Social Care & Services
Religious Activities
Gender
Grant-Making
Volunteerism
Youth



Other:

Please indicate the CIVICUS Programmes that are most relevant to your work by marking it with an X. If you already work closely with a CIVICUS programme, please mark the box with a P for Programme Partner. For more information about CIVICUS Programmes, please consult our brochure or the CIVICUS Website.
Civil Society Index
Civil Society Networks
Civil Society Watch
Legitimacy, Transparency, & Accountability
Global Call to Action against Poverty
Participatory Governance
World Assembly

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