CONFÉRENCE DES NATIONS UNIES SUR
LE COMMERCE ET LE DÉVELOPPEMENT
UNITED NATIONS CONFERENCE
ON TRADE AND DEVELOPMENT
ACCREDITATION QUESTIONNAIRE Hearing with civil society and the private sector 16 September 2009 Explanatory note: Civil society organizations 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 Communications, Information and Outreach 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. Mission statement 3. Copy of constitution/by‐laws/statutes 4. Most recent report or other reports of the organization with financial statements and a list of financial resources and contributions, including contributions from Government 5. List of members of the governing body of the organization and their countries of nationality 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 1
Name of organization and acronym: 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: Scope of organization (P
Please mark one of tthe ffollowing): Regional International Local National Year of establishment: Aims, objectives and activities of organization ((if sspace iis n
not ssufficient, p
please iinclude a
as attachments): Activities and programmes related to UNCTAD’s w
work ((if sspace iis n
not ssufficient, p
please iinclude as attachments):
Accreditation Questionnaire 2
Finances Latest annual budget of your organization (please specify income and expenditure): Indicate the sources of revenue of your organization (tick appropriate boxes): Membership dues Sales of publications Donations/grants from foundations Government grants/donations Grants from Intergovernmental bodies Donations from private sector Service fees Other (pls. specify) Membership (P
Please list members of your governing b
body a
and ccountries o
of n
nationality): Total number of members (individuals and/or organizations): List of countries of members: Accreditation Questionnaire 3
Relationship with international organizations:
Is your organization in consultative status with the United Nations Economic and Social Council? Yes / No
If yes, in what category? General Special Roster Is your organization 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 organization been accredited to an UNCTAD Conference in the past? If yes, please indicate the most recent session/year? Yes / No Application completed by: Name and title Accreditation Questionnaire Signature 4