Voluntary Action Network India

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VANI MEMBERSHIP FORM

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APPLICANT CATEGORY:	ORGANISATION
	NETWORK
	INDIVIDUAL
Full NAME ( ORGANISATION/ NETWORK):
POSTAL ADDRESS:
PIN CODE:
TELEPHONE NUMBERS: LANDLINE ( with Code) :
MOBILE:
Email:
Website
Year of Establishment:
Society Registration No.
Do you have FCRA
Membership fee Structure: Organisation/ Network	Organisation/ NetworkIndividual Annual- Rs.500 Annual- Rs.100 Long-term (5 Years) – Rs.2500 Long-term (5 Years) –Rs.500
(Kindly make payment in favour of Voluntary Action Network India by cheque/ Demand Draft) Mode of payment: Cheque / Demand Draft
Cheque/ DD details:
Attachments required ( you may note the following and send at VANI Office later) a. Two Recommendation letters from existing VANI members in your State. b. Annual Report with audited report last three years c. Brief statement of purpose for which organisation/Network wishes to become a member & what it believes it can offer to and receive from VANI. d. For Networks: List of the network members. e. List of Publications (if any) For Individuals: a. Detailed Bio data b. Two Recommendation letters from existing VANI members in your State. My organisation/I, assure that we/I will abide by VANI’s objectives/principles/values and will participate in VANI’s activities/programmes on a sustained basis and maintain an updated information base at VANI Secretariat by providing the required information on timely basis
Name of Chief Functionary: )
Designation:
Contact Details:
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Email:
Address: BB- 5, 1st Floor, Greater Kailash Enclave-II, New Delhi-48 Tel: -+91-11- 29228127/6632; 41435536 Fax: 41435535 Email: Info@vaniindia.org

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