Admission of NGOs to official partnership with UNESCO or of Foundations and other similar institutions to official relations with UNESCO APPLICATION FORM ANY REQUEST FOR PARTNERSHIP MUST BE ADDRESSED IN WRITING TO THE DIRECTOR-GENERAL OF UNESCO. THIS FORM DULY FILLED IN, AS WELL AS DOCUMENTS LISTED BELOW, SHALL ACCOMPANY YOUR LETTER TO THE DIRECTOR-GENERAL AND SHALL BE SENT TO THE FOLLOWING ADDRESS: Ms Audrey Azoulay Director-General United Nations Educational, Scientific and Cultural Organization 7, place de Fontenoy 75732 PARIS Cedex 7 SP France KINDLY SEND A COPY OF YOUR FILE TO : ngo@unesco.org PLEASE ATTACH TO THIS FORM A COPY OF: the instrument of legal recognition of the institution the statutes a detailed financial statement for the last financial year the latest activity report covering a period of at least two years a complete list of members by country or by category as provided in the statutes Before submitting your request, please read carefully the Directives governing UNESCO s official partnership with NGOs and foundations: Directives concerning UNESCO s partnerships with non-governmental organizations Directives concerning UNESCO s relations with foundations and similar institutions
General Information Official name of the NGO/ Foundation Original Language:. French, if applicable:...... English, if applicable:..... Date of Creation.... Website:...... Headquarters: (complete address) E-mail:..... Telephone:.... Fax:.. Contact person in the framework of this request : (name and address) Head: (Surname / First Name / Title) 1. Briefly summarize the objectives and the mission of your institution. 2. Briefly detail the internal structure of your institution. 2
3. Number of members of your institution. (Please attach the complete list of members by country or category as provided in the Statutes) 4. Types of members of your institution. Individuals Institutions Others, please specify.. 5. Indicate the geographical representation of your institution. International Regional/Sub-regional National 6. Please specify your most significant geographical representation (see the note at the end of the form) (several answers possible) Africa Arab States Asia and the Pacific Europe and North America Latin America and the Caribbean 7. Briefly summarize the activities of your institution. 8. Geographical scope of your activities. (several answers possible) Africa Arab States Asia and the Pacific Europe and North America Latin America and the Caribbean 9. Specify the funding arrangements benefitting your institution. (Optional for foundations and other similar institutions) 3
Partnership with UNESCO 10. Indicate the UNESCO fields of competence covered by your institution and briefly explain how this partnership could be beneficial for both organizations. 11. Briefly describe the projects you propose to implement in cooperation with UNESCO. 12. If applicable, briefly describe the activities already implemented in cooperation with UNESCO indicating the UNESCO Division/Unit and/or Field Office concerned. Brief description of the activity Venue Date Division/Field Office 13. Indicate if your institution already cooperated with a National Commission for UNESCO. Brief description of the activity Venue Date National Commission 4
Other Partnerships 14. Indicate if your institution maintains relations with other organization(s) of the United Nations system and/or other intergovernmental organization(s). Name of the organization Date Brief description of the activity 15. List non-governmental organizations and/or other institutions which are your privileged partners and, if possible, their websites. Name Website For additional information: Desk for Intergovernmental and Non-Governmental Organizations Sector for Priority Africa and External Relations UNESCO 7, place de Fontenoy 75732 PARIS Cedex 7 SP France e-mail: ngo@unesco.org * The distribution of countries in each region is as follows: i) Western Europe and North America: Andorra, Austria, Belgium, Canada, Cyprus, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Monaco, Netherlands, Norway, Portugal, San Marino, Spain, Sweden, Switzerland, Turkey, United Kingdom of Great Britain and Northern Ireland, United States of America; ii) Eastern Europe: Albania, Armenia, Azerbaijan, Belarus, Bosnia and, Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Hungary, Latvia, Lithuania, Montenegro, Poland, Republic of, Moldova, Romania, Russian Federation, Serbia, Slovakia, Slovenia, Tajikistan, the former Yugoslav, Republic of, Macedonia, Ukraine, Uzbekistan; iii) Latin America and the Caribbean: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Uruguay, Venezuela (Bolivarian Republic of); iv) Asia and the Pacific: Afghanistan, Australia, Bangladesh, Bhutan, Brunei Darussalam, Cambodia, China, Cook Islands, Democratic People s Republic of Korea, Fiji, India, Indonesia, Iran (Islamic Republic of), Japan, Kazakhstan, Kiribati, Kyrgyzstan, Lao People s Democratic Republic, Malaysia, Maldives, Marshall Islands, Micronesia (Federated States of), Mongolia, Myanmar, Nauru, Nepal, New Zealand, Niue, Pakistan, Palau, Papua New Guinea, Philippines, Republic of Korea, Samoa, Singapore, Solomon Islands, Sri Lanka, Thailand, Timor-Leste, Tonga, Turkmenistan, Tuvalu, Vanuatu, Viet Nam; v) Africa: Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Côte d'ivoire, Democratic Republic of the Congo, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, South Sudan, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia, Zimbabwe; vi) Arab States: Algeria, Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates, and Yemen. 5