INITIATIVES FOR PEACE AND HUMAN RIGHTS (IPHR)

INITIATIVES POUR LA PAIX ET LES DROITS HUMAINS (IPDH)

MEMBERSHIP APPLICATION FORM
First name: / Last name: / Title:
Profession: / Country of Residence:
Country of Citizenship:
Full address in the country of Residence:
Tel:
Mob. Tel: / E-mail: / Post code:
Membership category (Please choose one):
(1) Associate Member ☐ (2) Supporting member ☐
Are currently or have you been member of any other non-profit organization? If yes, Please name them below stating in few words their mission.
What do you expect to achieve in joining IPHR? (100 words max)
How could you contribute in IPHR’s vision of enhancing the culture of peace in the Great Lakes region?
How did you know about Initiatives for Peace and Human Rights (IPHR)?
I hereby accept to be bound by the Constitution of IPHR, and pledges to promote peace in my day-to-day life.
Date (DD/MM/YYYY): / Applicant’s signature:
Please, do not write here. RESERVED FOR ADMINISTRATVE USE ONLY
Application number:
Application received on (DD/MM/YYYY):
Application reviewed on (DD/MM/YYYY):
Decision of the General Assembly:

Admission process:

The following procedure shall be followed for the admission of new members of the IPHR

(a)All applications for membership shall be submitted to the Organization Secretary General who shall acknowledge their receipt and submit them to the General Assembly for consideration.

(b)All applicants shall be duly notified of the outcome of their applications immediately after their applications are reviewed.

(c)An applicant whose application for Associate Membership has been approved by the General Assembly shall be admitted to full membership upon payment of 15 USD subscription fee.

Complete and send your application form to:

Raymond NDAMAGE
Secretary General/ IPHR
Email: / With copy to: Elvis MBEMBE BINDA
President / IPHR
Email:

Please visit our membership page at for more information.

Please make sure your photo is pasted at the right place on this form. In case you could not paste it, please attach it to the email when submitting this form.

Thank you so much!

Towards Everlasting Peace through Widespread Human Rights and Good Governance Education