CONFÉRENCE DES NATIONS UNIES SUR
LE COMMERCE ET LE DÉVELOPPEMENT
UNITED NATIONS CONFERENCE
ON TRADE AND DEVELOPMENT
ACCREDITATION QUESTIONNAIRE ACADEMIC INSTITUTIONS Hearing with civil society and the private sector 16 September 2009 Explanatory note: Academic institutions that do not have observer status with UNCTAD and those that were not accredited to UNCTAD XII – and are interested in participating in the Trade and Development Board (TDB) hearing with civil society and the private sector, which will be convened as part of the annual session of the TDB from 14 to 25 September – are requested to complete and sign the application form. The completed application and the requested documents (please see list below) should be sent before the deadline of 7 August 2009 to the address below. Applications will only be taken into consideration if they are fully completed and signed. Civil Society Outreach Unit Intergovernmental Affairs and Outreach Service UNCTAD Palais des Nations 1211 Geneva 10, Switzerland Office: E‐ 8097 Fax: +41 22 917 00 56 Email: cso@unctad.org Checklist: Item 1. Completed application form 2. Copy of registration/by‐laws/statutes 3. Copies of relevant publications, brochures or other documentation 4. Copies of latest financial statements Pls. tick Disclaimer: Successful applications for accreditation do not constitute a responsibility on the part of UNCTAD to providing financial assistance for participation in UNCTAD's events, unless otherwise agreed to in writing. Accreditation Questionnaire for academic institutions 1
Name of University / Institution: Full address: (street and postal code) Telephone: Fax: E‐mail: Website: Contact person: Position/title: Country code:
Area code:
Number:
Country code:
Area code:
Number: Year of establishment: Aims, objectives and activities of institution ((if sspace iis n
not ssufficient, p
please iinclude a
as a
attachments): Activities and programmes related to UNCTAD’s w
work ((if sspace iis n
not ssufficient, p
please iinclude as attachments):
Accreditation Questionnaire for academic institutions 2
Finances Latest annual budget of your institution (please specify income and expenditure): Indicate the sources of revenue of your institution (tick appropriate boxes): Fees Sales of publications Donations/grants from foundations Government grants/donations Grants from Intergovernmental bodies Donations from private sector Other (pls. specify) Relationship with international organizations:
Is your institution in consultative status with the United Nations Economic and Social Council? Yes / No If yes, in what category? General Special Roster Is your institution in consultative status or special relations with any other United Nations organs, specialized agencies or other international organizations? Yes/ No
If yes, please provide details: Previous accreditations to UNCTAD: Has your institution been accredited to an UNCTAD Conference in the past? Yes / No
If yes, please indicate the most recent session/year? Signature of Dean / Head of Department: Name and title Accreditation Questionnaire for academic institutions Place and Date 3