World New Vision for Development

MEMBERSHIP FORM

Fill out the form below

1. Statement & Applicant Information

A. Applicant Identity Information

Fullname:

Marital Status:

Gender:

Date of Birth:

Nationality:

Phone number:

Son and /or Daughter of:

And of:

Home n°:

Street:

City:

State:

Coutry (Region):

Official Identity Document type:

Identity of document:

Issuing Date:

Place Issuing:

Expity date of Off. ID. Doc:

Issuing service:

B. Applicant job information

Position:

Curent Employer:

Your Line Manager’s Full Name:

Your Line Manager’s Position:

Website (if any):

Other Career (Precise):

Your Phone Contact:

And Email:

C. Applicant Spouse information (if any)

Spouse Full Name:

Date of birth:

Place of Birth

Nationality:

Phone Contact:

And Email:

2. CONSENT

I declare on my own belief that I have read out and understood WNVD’s mission and regulations and I freely adhere as: I accept to comply with the organization’s mission and to honestly accomplish my duties as member.
I confirm that I will strictly observe the organization’s guidelines and principles. I clarify that I have never try, nor will I ever attempt to be involved in any illegal action, including collaborative relationships or funding for harmful purposes against communities. During all my exercising time within the organization, I will kindly behave towards my colleagues and communities we serve for positively impacting a new moral and practices' model that lead to a true social and economic change. In accordance with the general provisions applicable to membership fee and updated on this date by the WNVD's Board of Directors, I agree to freely give the membership and contribution fee of:

3. Final Commitment Statement

I certify that the above provided information in answer to this ongoing procedure are true, complete and correct to the best of my knowledge and belief. I understand that any misbehavior or violation of the organization's charter and code of conduct may directly lead to my exclusion and later, to the loss of my quality and membership right.
Done on:

4. Reserved to the WNVD’s Board of Founders

We, WNVD's founding and co-founding members, gathered on by absolute majority, confirm having received the membership application from: as submitted on the date of: to the Presidency of our Board of Founders. His request has been subjected to a participatory and objective analysis and has resulted in a collective consensus, which has deliberately leaded us to attribute him and recognize him the right of:
Notice: He will comply with any other additional responsibilities that will be assigned to him, falling within the competence of the WNVD’s President of the Board of Directors and/or the CEO, and in accordance with one or the other position that he will be able to lead for the evolution of the organization.

Signed on

WNVD Headquarter.

BY WORLD NEW VISION FOR DEVELOPMENT

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