NGO and PO Accreditation Form(for those who want to join the Local Special Bodies of LGUs)

Annex “A”

MC #94-153

APPLICATION FOR ACCREDITATION OF NGO’s/PO’s/PS

Section 108 (RA 7160)

Name of NGO’s/PO’s/PS     : __________________________________________

Address                           : __________________________________________

Telephone No.                  : __________________________________________

Date Organized                 : ______________   Date Registered: ____________

Registering Agency           : (Please check appropriate box)

                             Securities and Exchange Commission

 

                             Cooperative Development Authority

 

                             Department of Labor and Employment

 

                             Department of Social Welfare and Development

 

                             Other (Please specify) ______________________________

NGO Organizational Level: (Please check appropriate box)

 

                   Community Based                                Affiliate of a large NGO

 

                   Chapter                                              Others (Please specify)

                                                                             _____________________

Sector Represented:

 

                   Management Organization                     Cooperative

 

                   Business Sector                                    People’s Organization

 

                   Others (Please specify) ___________________________________

Number of Members __________________

Purpose/Objective (please use additional sheet if necessary)

1.
2.
3.
4.
5.

Projects	Cost	Beneficiaries	Status

Please use additional sheet if necessary

Project Financing (Sources/scheme)

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

We hereby certify to the correctness of the above information.

                                                          _______________________

                                                                       Secretary

Attested

_______________________

Printed Name & Signature

Checklist of Requirements:

a.   Letter of Application

b.   Duly Accomplished application form

c.   Board Resolution signifying intention fro accreditation for the purpose of membership in the local special bodies.

d.   Certificate of Registration (SEC, CDA, DSWD, DOLE)

e.   List of Current Officers

f.    Annual Accomplishment reports for the preceding year; and

g.   Financial Statement of the preceding year.

 ===========================================

DILG NGO Form No. 03

PEOPLES/NON GOVERNMENTAL ORGANIZATION

(Application for Accreditation for Membership

in the Local Special Bodies)

APPLICATION REQUIRMENTS                                                        Check if Complied

1. PO/NGO APPROVED BOARD RESOLUTION                               _______________

2. CERTIFICATE OF REGISTRATION (Photocopy)                          _______________

3. LIST OF INCUMBENT OFFICERS                                                 _______________

4. LIST OF ACCOMPLISHMENTS                                                     _______________

5. MASTERLIST OF BONAFIDE AND ACTIVE MEMBERS             _______________

PO/NGO INFORMATION SHEET

1. COMPLETE NAME                                     : __________________________________

2. COMPLETE ADDRESS                               : __________________________________

3. DATE CREATED/ORGANIZED                 : __________________________________

4. DATE REGISTERED                                  : __________________________________

5. REGISTERING AGENCY                           (Please Check)

__________a. Securities and Exchange Commission (SEC)

__________b. Cooperative Development Authority (CDA)

__________c. Department of Labor and Employment (DOLE)

__________d. Department of Social Welfare and Development (DSWD)

__________e. Others (Specify) _____________________________________________)

__________f.  Not formally registered but the Sanggunian concerned recognized organization for purposes only of meeting the minimum requirements for membership of such organization(s) in Local Special Bodies.

6. NUMBER OF ACTIVE BONAFIDE MEMBERS: ____________________________

7. FREQUENCY OF MEETINGS (Please Check)

                        ___________ Monthly                        _____________ Semi Annually

                        ___________ Quarterly          _____________ Annually

8. Nature of Existence (Please Check)

                        ___________ Permanent                     _____________ Temporary

                        ___________ Semi-permanent

9. CATEGORY (Please Check)

                        _________ Agricultural                      ________ Civic                       ________ Labor

                        _________ Religious               ________ Social          ________ Business

                        _________ Occupational        ________ Professional            ______ Others (Specify)

10. LIST OF INCUMBENT OFFICERS (Requirement No. 03)

            NAME                                     POSITION                               TERM (YEAR)

___________________                      _______________________              ______________

___________________                      _______________________              ______________

___________________                      _______________________              ______________

___________________                      _______________________              ______________

___________________                      _______________________              ______________

___________________                      _______________________              ______________

___________________                      _______________________              ______________

___________________                      _______________________              ______________

___________________                      _______________________              ______________

AccreditationRAP

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