NGO Information Form

Section 1: General NGO Info

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Please make sure to fill in all required fields

(marked with a * and a light-blue background)

Please State:

Your Full Name:*
Position in your NGO:*
Your Contact Email:*
Your Contact Tel. Number:*

General NGO Information

NGO Acronym (Short Name):*

NGO Full Name:*

NGO Motto/Slogan, if any:

NGO Mission Statement:

LAOS HQ Address:*

Address 1:*
Address 2:*
City/Town:*
Province:*
PO Box:*

LAOS HQ Tel. Number:*

LAOS HQ Fax Number:

LAOS HQ Email:

LAOS HQ Website:

NGO Representative:*

Name:*
Official Title:*

Other Contact Person:

Name:
Official Title:

Number of Local Staff:*

Number of Expatriate Staff:*

Avg. Annual Operations Budget:

(in US$ only, please!)

In Laos Since:*

Major Donors, Contributors or Sources of Funds:
(Please give both FULL NAMES and ACRONYMS)

These are General NGO's Donors, NOT SPECIFIC to any Project. Project Donors should be listed in the Projects section.

Donor 1:
Donor 2:
Donor 3:
Donor 4:
Donor 5:

International Networks Membership:

List International Networks your NGO is a partner/member in:

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