Ministry of National Planning and Development

Registration Application Form for (INGO) Form B1

New Registration Form for the INGOs

(Please complete this form with computer typing)

PART I Organization Details
1.  / Type of Registration
( Please Tick only one) / New Registration
Renewal (this is the other type of registration)
2.  / Full Name of the Organization
3.  / Name of the Organization (Short form /ACRONYM)
4.  / Address in Country of origin / No. Street:
City: Country: Postcode:
Tel: Email:
Website:
5.  / Main Address in Somaliland / Street : District
Town Region
Tel: Email:
6.  / Country Director / Name:
Tel: Email:
7.  / Somaliland representative / Name:
8.  / Tel: Fax: Email:
9.  / Three alternative contact persons / 1. Name: Tel: Email:
2. Name: Tel: Email:
3. Name: Tel: Email:
10.  / Branch Offices in Somaliland / Region District
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PART II
1.  Sector(s) Working in:
Education / Health and Nutrient / Please specify the Other:
Economic / Governance
Water and Sanitation / Infrastructure
Environment / Production
2.  Targeted geographical area(s) of operation (regions, districts):
Region Town District
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3.  Planned timeframe for operations in Somaliland (if known):
4.  Total n umber of local staff
5.  Total number of International staff
Expatriate Personnel Working in Somaliland
No. / Name / Position / Qualifications / Visa type (single/multiple)
1
2
3
4
5
6
6.  Locally Recruited Staff (list all positions in the permanent organizational structure of the office – i.e. excluding those recruited only for a specific project – whether currently filled or not. Include all support staff – drivers, watchmen, cleaners, etc. ):
No. / Name / Position / Location / Monthly Salary
1
2
3
4
5
6
Section 3 Declaration
I declare that the information I have provided here is true and correct to the best of my knowledge.
Name : / Position / Signature / Date:
Section 4 Check List of attachments
1.  / A certificate of registration from country of origin and a proof of own operating office in country of origin.
2.  / Evidence of similar work carried out in the country of origin or in other countries (Reports, certificates of registration, LOA etc.)
3.  / Proof of funds secured from a donor. (Offer letter, contract, account statement etc.)
4.  / A profile of the organization which includes its aim, structure, head office, other countries where it is working or is registered
5.  / A copy of the organization’s constitution
6.  / One year activity plan, with sources of funds, and itemized budget for operations in the country
7.  / A receipt or proof of payment of the registration fee (from Ministry of Finance)
8.  / An attestation of your existence from the foreign office of the country of origin or the nearest embassy and declaration of responsibility for your actions
9.  / The CVs of your international staff and certificate of no criminal conviction from their respective countries
10.  / A written justification of international staff as to why they are needed
11.  / CVs of the founders or current of Board of Directors, their passport-sized photos and certificates of no criminal conviction in their countries
12.  / Proof that the objectives of your programs are consistent with national policies, plans and priorities
13.  / A letter of intent or agreement with the ministry you want to work with
14.  / A program or a project which fits into the work plan of the ministry or the agency you are working with
15.  / An evidence of an own office with a decision making authority in the country
16.  / New Registration Fee: US$ 1000
Office Use Only ( Please do not complete this part)
Registrar’s Decision
Approval
Re- submission (More Information)
Rejection / Justification
Name of the Registrar: / Signature:
Date:
Director General’s Decision / Name:
Approval
Re-submission / SIGNATURE:
Rejectiuon / DATE:

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