/ Candidature Form for the election of
Board of Governors - Mandate 2009-2012

If your organisation is a World Water Council active member*, and that you wish to propose your organisation as a candidate for election to the Board of Governors of the World Water Council, please fill in the following form and return it to the World Water Council Headquarters ( address below) before 16 August 2009.

Responses may be continued on a separate sheet of paper if necessary. Please note that the information presented in this Form will be published on the World Water Council website.

* Are considered as active members: Members up to date with their yearly membership fees, including rears at the latest on 16 August 2009.

Information on your Organisation:

Organisation: / Acronym:
Country of establishment: / Year of establishment:
Please indicate the college to which your organisation belongs:
College 1: Intergovernmental institutions
College 2: Governments and government authorities (not including state-owned universities, research centres or state-owned companies)
College 3: Enterprises and facilities
College 4: Civil society organisations and water user associations (not including NGO’s whose main activities are training and education)
College 5: Professional associations and academic institutions
N.B: The college classification does not take into account the legal incorporation status of the organisation but only the role played within the water management process. If you are not sure in which college belongs your organisation you can consult the college definition on WWC website:
Scope of your organisation: / Local / Regional: sub-national / National / Regional: multi-national / International
Are your organisation’s activities focused primarily on water and sanitation? Yes No
Please indicate your organisation’s field(s) of expertise and activities:
Water resources management Water supply or sanitation Regulation and governance
Basic human needs or health
Development or infrastructure
Climate or natural hazards
Environment or ecosystems / Agriculture or food production
Human rights or social iIssues
Education or capacity building
Human settlements or habitat / Economics or finance
Research or development
Energy or industry
Media or awareness
International cooperation or humanitarian helief
You may specify your activities by providing a list of more precise keywords:
Description of Your Organisation’s Activities:

Organisation Statement:

Please describe the involvement of your organisation within the World Water Council and state how long it has been involved in World Water Council activities:
For what reasons do you wish your organisation to have a seat on the Board of Governors?

1

World Water Council Espace Gaymard, 2-4 Place d’Arvieux, 13002– France

Fax: +33 4 91 99 41 01 / e-mail:

/ Candidature Form for the election of
Board of Governors - Mandate 2009-2012

Designation of Your Representative:

First Name: / Surname:
Title (Prof/Dr/Ms/Mr/Mrs): / Position:
Date of Birth: / Gender: / Nationality:
Tel: / Fax: / E-mail:
Please state in a maximum of 100 words his or her background (various positions held) and relevant experience and expertise that would benefit the Board of Governors of the World Water Council:
Is he or she a member of any other organisations? Yes No
Which ones?
If yes, does he or she hold an elected position within that/those organisation(s)? Yes No

Designation of Your Alternate Representative:

First Name: / Surname:
Title (Prof/Dr/Ms/Mr/Mrs): / Position:
Age: / Nationality:
Tel: / Fax: / E-mail:
Please state in a maximum of 100 words his or her background (various positions held) and relevant experience and expertise that would benefit the Board of Governors of the World Water Council:
Is he or she a member of any other organisations? Yes No
Which ones?
If yes, does he or she hold an elected position within that/those organisation(s)? Yes No

Declaration:

We (name of the organization), if elected to the Board of Governors, hereby agree to serve and uphold the Objectives, Constitution and By-Laws of the World Water Council.

We hereby commit to paying the annual membership fees during the three-year period of our mandate.

We also agree to pay all the travel expenses for our representative and alternate representative, as designated above, each time either or both of them attend a meeting of the Board of Governors of the World Water Council.

1

World Water Council Espace Gaymard, 2-4 Place d’Arvieux, 13002– France

Fax: +33 4 91 99 41 01 / e-mail: