ICAE Membership Application Form  
 
Membership Category
Please check the category for which you are applying:
Regional
 National
 Sectoral
 Associate

Friends (non-voting)
 I would like to become a Friend of ICAE for 2008 and make a donation to support the international adult education movement of:
US$
   
Contact information (Friends only):


Name of organization:
English
French
Spanish

Working language/s:

Acronym: (if any)

Mailing Address:
P.O. Box:
Street:
City:
State/Province:
Postal Code:
Country:
Telephone:
Fax:
E-mail:
Website:


President/Chairperson
(full name, titles):

General Secretary or Chief Executive
(full name, titles):

Contact Person
(full name, titles):

Legal status of the Organization:

Year founded:

Mission statement and aims of the Organization (briefly):


 Please check the issues your organization is involved in:
 Adult literacy:
 Grassroots communication and information efforts:
 Primary health care:
 Literacy and basic education:
 Local community development:
 Gender issues/education:
 Work issues:
 Citizenship education:
 Adult education in prisons:
 Peace education, human rights and conflict resolutions:
 Globalization and social movement:
 Social justice:
 Training of the educators of adults:
 Advocacy/Policy:
Other

 

Membership Fee

Please state (in USD) your Organizations' Annual Turnover: ________________________________________

The following membership fees apply (please mark accordingly):

USD 600 Organizations with annual turnover of USD 1.000.000 or above

USD 150 Organizations with annual turnover of less than USD 1.000.000

 

Application made by:_______________________                    Date:_______________________________

 


 

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