Devcon

Annual Membership Form
Organization Name
Address
Phone
Fax
Email Address
Web Address
Geographical Areas of Working
Year of Inception/Start
Total Male Staff
Total Female Staff
Your NGO is working in	Number Of Districts
	Number Of Villages
Direct Beneficiaries	Number Of Male
	Number Of Female
Registered	Yes No
Registered Under
Programming Areas	Select All that apply
	Health
	Education
	Disaster Preparedness
	Livelihood
	Agriculture
	Peace &Advocacy
	Microfinance
	Other
Other Area (If Any)
Category	A B
Name
Designation
Date	September 7, 2008
Province