NetHope Application for Membership 2010

Document Sample
NetHope Application for Membership 2010 Powered By Docstoc
					                                                                                 P.O. Box 6704
                                                                            McLean, VA 22106
                                                                        Office: 1.703.388.2845
                                                                        Fax: 1.703.388.2846

Dear Prospective Member,

We welcome your consideration of an application for membership to join NetHope. Through our
membership application process we want to encourage members interested in and able to support
NetHope over the long term. Our intent is to cultivate members who will both benefit from and
contribute to NetHope, and ultimately strengthen our alliance through their contribution of time and
expertise as well as financial and other contributions.

We are interested in attracting members who are committed to supporting NetHope's charitable
activities such as knowledge sharing, educational seminars, or advisory IT services for emerging
countries. We do not consider those with potential conflicts of interest, for example, organizations
that may provide NetHope with donations or vendor services or that offer development services for

As a lean organization, we have designed our membership process to be straightforward to explain
and simple to administer, thereby minimizing time to implement and execute. NetHope is a highly
collaborative organization. Commitment to partnership and collaboration, and organizational fit are
key elements of our success.

In addition to this application and required supporting documentation, we may request an interview
with you and one or more NetHope members or staff.

NetHope membership fees and annual dues are based on annual expense level from your
organization's most recent fiscal year as follows:

               Annual Expenses                            Annual Dues      One-time initial fee
                                                                             (50% of dues)
 US$75 million and above                                   US $16,500          US $8,250
 Below US$75 million                                       US $8,250           US $4,125
 1-2 additional Alliance or Federation
 members (each)                                            US $5,500           US $2,750
 3rd or more additional entities (each)                    US $3,300           US $1,650

If you have any questions regarding the application or membership process, please do not hesitate
to contact me. Thank you for your interest in NetHope.


Dr. William A. Brindley
Chief Executive Officer and Executive Director
NetHope, Inc.

NetHope Membership Application August 1, 2008 (fiscal year 2009)
NetHope Membership Application (2010)            

Name of Organization:                                              Address:

Name/Title of Person Submitting Application:

Telephone work:
Telephone mobile:
Telephone fax:
Total Organization Annual Expense (USD): (most recent         Total Annual Program Expense (USD):
fiscal year)
# of Countries Where Organization Works - Please Attach List:                     # of Staff Worldwide:

# and Names of Regions Where You Work1:

Are you a recognized nonprofit by the government of your country?                         Yes □     No□
If providing emergency relief, does your organization observe the:                        Yes□      No□
Code of Conduct for The International Red Cross and Red Crescent Movement and NGOs in
Disaster Relief, and Humanitarian Charter and Minimum Standards in Disaster Response?2
(Provide comments if needed)
Please provide two examples of how your organization has advanced its mission through networking services
to country offices or regions (attach or type below):

Please briefly describe your management and governance structure (attach or type below):

Please provide your organizational status with “watch-dog” organizations: BBB; Charity Navigator, Guidestar
If non-USA based – an equivalent type body:

Please sign and date:

Signature                                                Date
With your application please submit the following for your organization:
     Three (3) copies of your vision/mission statement.
     Three (3) copies of most recent annual report and audited financials, if not in annual
     Documentation that your government recognizes your organization as a nonprofit.
     List of countries where your organization works.
     Letter expressing your organization's intent to join NetHope, if accepted
If materials are available online, please email and provide one set of hardcopy documents
Thank you for your interest in NetHope.
Please digitally scan/email (preferred) or mail your signed application and documents to:
William Brindley, CEO                 John Watts, Chairman Membership Committee
NetHope, Inc.                   and ChildFund International
P.O. Box 6704                         2821 Emerywood Parkway
McLean, VA 22106, USA                 Richmond, Virginia 23294-3725, USA       

  For example: recognized development regions of the world - Africa, Asia, Europe, Latin America, North America,

NetHope Membership Application August 1, 2008 (fiscal year 2009)
NetHope Membership Application August 1, 2008 (fiscal year 2009)

Shared By: