QUESTIONNAIRE - Lists
QUESTIONNAIRE - Lists
QUESTIONNAIRE - Lists
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<strong>QUESTIONNAIRE</strong><br />
• Presentation of your NGO or Group :<br />
Name -----------------------------------------------------------------------<br />
Type of structure -----------------------------------------------------------------------<br />
Number of members -----------------------------------------------------------------------<br />
Contact person -----------------------------------------------------------------------<br />
Phone number -----------------------------------------------------------------------<br />
Address -----------------------------------------------------------------------<br />
E-mail -----------------------------------------------------------------------<br />
Field of expertise: □ Culture □ Development<br />
□ Education □ Environment<br />
□ Humanitarian □ Human rights<br />
□ Political □ Social<br />
□ Other (specify) -------------------------------------------<br />
If your NGO or group corresponds to more than one category, please mention your<br />
order of priority. --------------------------------------------------------------------------------<br />
------------------------------------------------------------------------------------------------------<br />
• If you don’t fit in any of the above categories, but would like to attend as an<br />
observer, please let us know.<br />
------------------------------------------------------------------------------------------------------<br />
• Is your action exclusively targeted at a specific religious community<br />
□ Yes □ No<br />
□ Observations ---------------------------------------------------------------------------------<br />
------------------------------------------------------------------------------------------------------<br />
• Are you directly affiliated to a political party
□ Yes □ No<br />
□ Observations ---------------------------------------------------------------------------------<br />
------------------------------------------------------------------------------------------------------<br />
• Would you be interested to take part in the Forum<br />
□ Yes □ No<br />
□ Observations ---------------------------------------------------------------------------------<br />
------------------------------------------------------------------------------------------------------<br />
• Define your mission (briefly) --------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
---------------------------------------------------------------------------------<br />
• History (founding, actions) ----------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
• Your current priority (topics of interest, projects): -----------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
--------------------------------------------------------------------------------------------------<br />
• Would you be part of a round table with other NGOs who share the same<br />
priorities<br />
□ Yes □ No<br />
□ Observations ---------------------------------------------------------------------------------<br />
------------------------------------------------------------------------------------------------------
• Would you know any NGOs or groups likely to be interested by our Forum If<br />
yes, please mention their name, object, contact person, phone number and/or<br />
e-mail.<br />
------------------------------------------------------------------------------------------------------<br />
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