NGO Registry Form

 Ministry of Planning and Development Cooperation NGO Registration Form In addition to the information in this form, please submit a copy of the following: 1) NGO's articles of association, constitution, or other document stating its aims, objectives, governing structure, sources of funding, and planned activities in Iraq. 2) Financial documention including a complete statement of revenue and expenses and assets and liabilities for the current year and the previous three years (or the years the organization has existed, if less than four). If the applicant has existed for less than one year, it must give financial data for the current year and projected budget for the next two years. 3) Foreign NGOs must submit a notarized copy of registration or other proof that it is a legal entity in a foreign country and proof that the NGO is registered as a not-for profit entity in its jurisdiction of organization. 4) Written statement by an authorized representative of the NGO's headquarters stating that the organizations is non-political, non-profit making, non-governmental, and does not discriminate on the basis of race, religion, or national or ethnic origin.  Organization Info Full Name of Organization Nationality Primary Issue Area --Primary Issue Area-- Agriculture Art/Culture Democracy/Governance Economic Development Education Environment, Conservation Handicapped Human Rights Humanitarian Assistance Media Orphans/Children Public Health/Medical Public Services/Infrastructure Shelter/Housing Womens Issues Youth/Sport Brief Mission Statement Page2 Contact Information Provide Organizaiton Information Only, Not Personal Information Contact Name Contact Title Iraq Office Address Iraq Office Phone Locations of Any Additional Offices in Iraq International Office Address International Office Phone E-mail Office Fax Contact information of any other individuals in Iraq authorized to represent the organization and to receive official notices: Page3 Legal Information Domestic NGOs: List names of Board of Directors Foreign NGOs: List names of head of mission and head of organization List any members of the governing body who are also public officials or employees of any government or governmental entity in Iraq List any organizations or individuals that control the NGO, or any organizations that are controlled by the NGO: List names and office addresses of any substantial contributors, amount of the contribution, and relationship of the contributor to the NGO List loans to the NGO in excess of 10,000,000 Iraqi dinarii or 2% of its total revenues. Identify amount and lender Foreign NGOs only: Date of Arrival of the NGO's representative(s) in Iraq (if application is made inside Iraq): Provide a complete list of any previous visits to or activities in Iraq conducted by the NGO: