Membership Online Registration Form

(Please fill in all details)
We wish to join the World Kindness Movement (WKM).

Name of Organisation:
Registration number:Application Date:

Address: Country:Postal Code (Zip Code)

Your Email:Website Address:

Contact Person

Mr/Ms/Mdm/Miss/Dr (please delete as appropriate)
Position:
Telephone Number: (Mobile/Cell)

Fax Number:

Your Organisation’s Strategic Plan
Please explain how becoming a member will assist in achieving your organisations goals?
What will your organisation be able to contribute to the global initiative?
Provide contact details for 2 references we will be able to contact who are aware of your organisations activities, (preference 1 government eg school government official and 1 private sector eg personal company that supported campaign)

Provide email us a scanned copy of your official certificate of registration of the Not For Profit Organisation provided by the respective government agency with application.
Name: Position:
Signed: Date:

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