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Job Location
Address
City *
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State/Province *
Country *
Description
Organisation Information
Web Site Address
Name *
Email Address
Address *
Address 2
City *
State *
Zip/Postal Code *
Country *
Contact Person
First Name
Last Name
Phone Number
Email Address


Security test. Please identify the pictures:
Name *
Email *
Phone *
Mobile
Fax
Country
Province
Town
Number of adults
Number of Children
Arrival Date
Departure Date

Comments

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Thank you for choosing to join or renew your membership to CIVICUS. This is a three step process where (1) we collect your personal details; (2) you select the category of membership and associated fee; and (3) an online credit card payment is made.

Alternatively, should you not want to make an on-line payment, click here for the Membership Application Form (in English, French, and Spanish) and follow the guidelines to make payment of membership fees by cheque, wire transfer, credit card, or Money Gram / Western Union.

  • I / We have read and understand CIVICUS' vision, mission and values and agree to support them.
  • Please note: All fields marked with a “*” are required in order to complete this process. Please type in N/A (not applicable) if you are unable to complete the field.

  • Any items that we should not post on CIVICUS please check box

Transaction Type: New Membership Membership Renewal
First Name: *
Last Name: *
Job Title: *
Organisation Name: *
Postal Address: *
Country *
Telephone: *
Fax: *
Email: *
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
Annual income in US$ or Euros € Cost
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

Payment made by: (name as it appears on credit card) *

What areas/fields is your organisation mainly involved in? Check all fields that apply.
Civil Society Strengthening/Support Democracy & Governance Human Rights & Legal Issues
Health Culture & Recreation Education & Research
Environment Charitable Purposes Housing/Homelessness
International Development Community Development Professional Association/Union
Economic Development Social Care & Services Religious Activities
Other:
Security test. Please identify the pictures:
Name *
Email *
Phone *
Mobile
Fax
Country
Province
Town
Number of adults
Number of Children
Arrival Date
Departure Date

Comments

Security test. Please identify the pictures:






Thank you for choosing to join or renew your membership to CIVICUS. This is a three step process where (1) we collect your personal details; (2) you select the category of membership and associated fee; and (3) an online credit card payment is made.

Alternatively, should you not want to make an on-line payment, click here for the Membership Application Form (in English, French, and Spanish) and follow the guidelines to make payment of membership fees by cheque, wire transfer, credit card, or Money Gram / Western Union.

  • I / We have read and understand CIVICUS' vision, mission and values and agree to support them.
  • Please note: All fields marked with a “*” are required in order to complete this process. Please type in N/A (not applicable) if you are unable to complete the field.

  • Any items that we should not post on CIVICUS please check box

Transaction Type: New Membership Membership Renewal
First Name: *
Last Name: *
Job Title: *
Organisation Name: *
Postal Address: *
Country *
Telephone: *
Fax: *
Email: *
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
Annual income in US$ or Euros € Cost
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

Payment made by: (name as it appears on credit card) *

What areas/fields is your organisation mainly involved in? Check all fields that apply.
Civil Society Strengthening/Support Democracy & Governance Human Rights & Legal Issues
Health Culture & Recreation Education & Research
Environment Charitable Purposes Housing/Homelessness
International Development Community Development Professional Association/Union
Economic Development Social Care & Services Religious Activities
Other:
Security test. Please identify the pictures:
Email Address: *
Subscribe to: Civil Society Index Quarterly Newsletter

Civil Society Watch Monthly Bulletin

e-CIVICUS en francais

e-CIVICUS HTML Version

e-CIVICUS Text version

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