Organizational Profile:
Full name of organization
Acronym
Type of Organization
-- Select an Option -- Non-Governmental Organisation Faith-Based Organizations Community-based organizations
Country of Operation
-- Select an Option -- Nigeria Benin Burkina Faso Cape Verde Ghana Guinea Guinea-Bissau Ivory Coast Liberia Mali Mauritania Niger Saint Helena Senegal Sierra Leone The Gambia Togo
State in Nigeria
Abia Adamawa Akwa Ibom Anambra Bauchi Bayelsa Benue Borno Cross River Delta Ebonyi Edo Ekiti Enugu Federal Capital Territory Gombe Imo Jigawa Kaduna Kano Katsina Kebbi Kogi Kwara Lagos Nasarawa Niger Ogun Ondo Osun Oyo Plateau Rivers Sokoto Taraba Yobe Zamfara
Region in Ghana
Northern Ashanti Western Volta Eastern Upper West Central Upper East Greater Accra Savannah North East Bono East Oti Ahafo Bono Western North
Region in Cape Verde
Boa Vista Brava Fogo Maio Sal Santiago Santo Antão São Nicolau São Vicente
Region in Burkina Faso
Boucle du Mouhoun Cascades Centre Centre-Est Centre-Nord Centre-Ouest Centre-Sud Est Hauts-Bassins Nord Plateau-Central Sahel Sud-Ouest
Region in Benin
Alibori Atacora Atlantique Borgou Collines Couffo Donga Littoral Mono Ouémé Plateau Zou
Region in Guinea
Boké Conakry Faranah Kankan Kindia Labé Mamou Nzérékoré
Region in Guinea-Bissau
Bafatá Biombo Bissau Bolama (Bijagos) Cacheu Gabú Oio Quinara Tombali
Region in Ivory Coast
Abidjan Bas-Sassandra Comoé Denguélé Gôh-Djiboua Lacs Lagunes Montagnes Sassandra-Marahoué Savanes Vallée du Bandama Woroba Yamoussoukro Zanzan
Region in Liberia
Bomi Bong Gbarpolu Grand Bassa Grand Cape Mount Grand Gedeh Grand Kru Lofa Margibi Maryland Montserrado Nimba Rivercess River Gee Sinoe
Region in Mali
Bamako Gao Kayes Kidal Koulikoro Mopti Ségou Sikasso Tombouctou
Region in Mauritania
Adrar Assaba Brakna Dakhlet Nouadhibou Gorgol Guidimaka Hodh Ech Chargui Hodh El Gharbi Inchiri Nouakchott Tagant Tiris Zemmour Trarza
Region in Niger
Agadez Diffa Dosso Maradi Niamey Tahoua Tillabéri Zinder
Region in Saint Helena
Ascension Gough Island Inaccessible Island Nightingale Islands St. Helena Tristan da Cunha
Region in Senegal
Dakar Diourbel Fatick Kaffrine Kaolack Kedougou Kolda Louga Matam Saint Louis Sedhiou Tambacounda Thies Ziguinchor
Region in Sierra Leone
Kailahun Kenema Kono Bombali Kambia Koinadugu Port Loko Tonkolili Bo Bonthe Moyamba Pujehun Western Area Rural Western Area Urban
Region in Gambia
Banjul Basse (Upper River) Brikama (Western) Janjanbureh Kanifeng Kerewan (North Bank) Kuntaur Mansakonko (Lower River)
Region in Togo
Centrale Kara Maritime Plateaux Savanes
Head Office Address
Telephone Number
E-mail Address
Website
Year of Establishment
Vision Statement
Mission Statement
Core Values
What are your main activities?
Number of Staff (both full and part time)
Number of Volunteers
Annual Budget
-- Select Option -- $500 – $10,000 $10,000 – $30,000 $30,000 – $50,000 $50,000 – $10,0000 $100,000 – $1,000,000
Annual Expenditure
-- Select Option -- $500 – $10,000 $10,000 – $30,000 $30,000 – $50,000 $50,000 – $10,0000 $100,000 – $1,000,000
Source of funding
Contact Person(s):
Full Name
Telephone Number
Position/Designation
Referee(s):
1. Referees Name
1. Referees Organization & position
1. Referees Telephone Number
1. Referees E-mail Address
2. Referees Name
2. Referees Organization & position
2. Referees Telephone Number
2. Referees E-mail Address
Upload Relevant Documents:
Certificate of Registration with the Government.
Report of activities related to TIP and SOM
Organizational profile.
Organization constitution.
Letter of Expression of Interest to join WACTIPSOM.
Message
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