Contribution Form Trust Fund Twinning Funds A unique, over-arching mechanism to develop and promote strategies and partnerships among national governments, intergovernmental and non-governmental organizations. IFCS provides an open, transparent and inclusive forum for discussing issues of common interest and also new and emerging issues in the area of sound management of chemicals. IFCS plays a unique multi-faceted role as a flexible, open and transparent brainstorming and bridge-building forum for Governments, intergovernmental organizations and non-governmental organizations including from the private sector. This role has facilitated consensus building on issues and actions addressing the sound management of chemicals. By its efforts it contributes to the implementation of the Strategic Approach to International Chemicals Management (SAICM) and the work of other chemicals-related international organizations and institutions. Why a Trust Fund? In establishing the IFCS, governments recognized and agreed that it would have to be financed through voluntary extra-budgetary contributions. The reasons for the Trust Fund method of financing the Forum were: openness to voluntary rather than assessed contributions. provision for flexibility in funding by enabling surpluses or deficits from one accounting period to the next. acceptance of non-governmental monies as contributions. no minimum or maximum limits for contributors. The day-to-day administrative and operational expenses of the IFCS including events (workshops, conferences) and meetings, Secretariat support staff salaries, publications and mailings, supplies, and other office operating costs are covered by the Trust Fund. Twinning Funds The Twinning Funds assist participation by the developing countries and non-governmental organizations at IFCS events and meetings where they become part of the contributing solution to global chemical safety. Without this financial support to cover travel and accommodation costs, their participation would be extremely limited. Please see the information sheets on the Participation of Developing Countries via Twinning Funds Assistance and Participation of Non-governmental Organizations via Twinning Funds Assistance. The special twinning account will be administered in accordance with any conditions specified by the contributor. To assure fairness, IFCS has adopted guidelines, in accordance with IFCS policies and procedures, for selection of participants requesting financial assistance. How Your Organization Can Contribute Please turn the page for information on how and where contributions can be sent. Intergovernmental Forum on Chemical Safety (IFCS) c/o World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland Tel: +41 (22) 791 3873 / 1334 / 3650; Fax: +41 (22) 791 4875; Email: ifcs@who.int; Website: www.ifcs.ch IFCS Contribution Form: Trust Fund / Twinning Funds Organization:______________________________________________________________________________ Department:_______________________________________________________________________________ Full Mailing Address:_______________________________________________________________________ __________________________________________________________________________________________ City/State/Code:_____________________________________________Country:_______________________ Phone:____________________ Fax:____________________ Email:_________________________________ Name of Person:_______________________________ Title: ______________________________________ Contribution to (see below): Currency (country): _______________ Total Amount __________________ Signature:___________________________________________ Date:_________________________________ Trust Fund and Twinning Fund Contributions can be made to the Trust Fund or Twinning Fund, via bank transfer, to: Make bank transfers to: UBS AG Case Postale 2600 (2 rue de la Confédération) CH-1211 Geneva 2, Switzerland For credit to: IFCS (World Health Organization) Important: In order for the IFCS Secretariat to be able to verify that the funds have been received and credited to the right account, a letter or this form should be mailed or faxed to Dr Judy Stober, Executive Secretary - IFCS, informing on the contribution and clearly stating its purpose / designation. Tel: +41 (22) 791 1334/3873 Fax: +41 (22) 791 4875 E-mail: ifcs@who.ch Deposits in Euros: to Account No. 240-C0-169.920.1 IBAN code: CH85 0024 0240 C01699201 Deposits in Swiss Francs: to Account No. 240-C0-158.200.0 IBAN Code: CH81 0024 0240 C01582000 Deposits in US$ and other currencies: to Account No. 240-C0-169.920.3 IBAN Code: CH31 0024 0240 C01699203 Swift Code for all accounts: UBS WCH ZH 80 A Contribution Amount(s): Trust Fund:____________________________________________ Intergovernmental Forum on Chemical Safety Twinning Fund Developing countries:______________________ World Health Organization Twinning Fund NGOs:___________________________________ 20 Avenue Appia (6/04) Intergovernmental Forum on Chemical Safety (IFCS) c/o World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland Tel: +41 (22) 791 3873 / 1334 / 3650; Fax: +41 (22) 791 4875; Email: ifcs@who.int; Website: www.ifcs.ch