Organization’s Register
Instructions: Please complete form in BLOCK letters
Email address *
NAME OF ORGANIZATION:
Your answer
MAILING ADDRESS:
Your answer
CITY/TOWN/VILLAGE:
Your answer
COUNTRY:
Your answer
LEADER OF THE ORGANIZATION:
TITLE: (E.X. PRESIDENT; CHAIR)
Your answer
CONTACT INFORMATION FOR ORGANIZATION
PHONE NUMBER:
Your answer
WEBSITE:
Your answer
IS THIS A LEGALLY REGISTERED ENTITY?
NAME OF THE PERSON DOING THE REGISTRATION ON BEHALF OF THE ORGANIZATION:
Your answer
CONTACT NUMBER:
Your answer
BANKING INFORMATION
(Note: Disbursement will be made to Committee/Organization Accounts for transparency. If an account does not exist in the name of Organization or Committee, an invoice of a product or service utilized for events can be provided.)
ACCOUNT NAME
Your answer
NAME OF BANK *
Other
Your answer
BANK ACCOUNT
Your answer
DATA ENTRY
THIS INFORMATION WAS ENTERED BY:
If Other (please provide name)
Your answer
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