NACC PARTNERSHIP APPLICATION FORM
Organization Name *
Your answer
Type of partner you’d like to sign up as *
Name (surname first) *
Your answer
Email *
Your answer
Address street 1 *
Your answer
Address Street 2
Your answer
City/State *
Your answer
Country *
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Phone number
Your answer
Would you like to receive postal mail from the Alliance?
Organization Information
Organization Type *
Fuels and technologies (you can tick more than one) *
Required
Sectors of experience and expertise (you can tick more than one) *
Required
Fill the section below with maximum of 5 rows of text
Please briefly explain the primary sectors that most closely represent your organization's experience and expertise *
Your answer
Mission/summary: Please provide one or two paragraphs describing your organization's mission, and its work and/or interest in clean cookstoves and fuels. Please include details on any initiatives underway to reduce exposure to indoor air pollution, and your respective goals and successes to date *
Your answer
Initiatives/targets/scale: Please provide details on any initiatives underway, including countries, characteristics of your target populations (urban/rural, socio-economic status) and the scale of the initiatives (community/state/national/international level) and the nature and scope of the intervention *
Your answer
Social/Cultural barriers: Please comment on your experience and/or interest in social/cultural barriers to using traditional fuels and stoves *
Your answer
Market development: Please briefly describe how your organization would like to participate in the partnership, including how your organization can contribute (e.g. experience, skills, etc.) *
Your answer
Please list any attachments you would like to include as part of your application here and email them to info@nigeriacleancooking.org *
Your answer
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