UNITED NATIONS WOMEN’S ASSOCIATION IN BANGLADESH
MEMBERSHIP APPLICATION/RENEWAL FORM 2004-2005

(Please block print legibly)

Name:

 

Address:

(House)

(Road)

(Area)

Home Tel:

 

Mobile Tel:

 

Office Tel:

 

E-mail:

 

Country (of Nationality):

 

 

 
TYPE OF MEMBERSHIP

NEW RENEWING

 

FULL (UN or Affiliated Agencies)

 

Name of Agency:

 

 

Name of UN Staff Member:

 

 

Staff Member’s Title:

 

ASSOCIATE (Non-UN)

 

Name of Mission/Office:

 

 

Name of Spouse:

 

 

Title of Working Person:

 

EMPLOYMENT:

Full-Time

Part-time

Arrival in Bangladesh (M/Y):

 

Probable duration of stay:

 

 

Please check one or more activities or committees you would like to participate in:
Executive Board Activities (Tours, aerobics, study groups, etc.)
Membership Committee Programmes (Organising meetings, speakers, etc)
Hospitality Committee UN Ball Committee
Publications Committee Welfare
Distribution of WOMUN Fundraising
Updating “Settling in Bangladesh” Other:
Website Publishing    
 
Signature: Date submitted:

Please submit this form to the Membership Chair with your Membership Fee, Tk.1000
Deadline for Membership Renewal: June General Meeting.

Receipt No.__________________________