<p> Debate to Action Building Capacity in Youth Organisations</p><p>A British Council/World Bank Institute Project</p><p>APPLICATION FORM for ORGANISATION</p><p>Please complete carefully, using block letters, PC or typewriter, and return the Application Form to:</p><p>Debate to Action Coordinator British Council Liberia Road P. O. Box GP771 Accra</p><p>British Council and the World Bank do not discriminate on the basis of gender, ethnicity, religion, or disability status.</p><p>Name of organisation</p><p>Address Telephone</p><p>Mobile</p><p>Mailing address (if different) Fax</p><p>E-mail</p><p>Does your organization have access to the If your organisation has a website, please Internet, and if so, how? state the address here:</p><p>Connection at organisation Internet café or other paid-by-usage access Public or free access outside organisation Other Do not use Internet </p><p>How many members or volunteers does your organisation have? Approximately what percentage of your members/volunteers is female?</p><p>Approximately what percentage of your members/volunteers has disabilities?</p><p>Is your organisation an umbrella organisation?</p><p>Yes No</p><p>If yes, how many member organisations do you represent?</p><p>When was your organisation founded?</p><p>Is your organisation registered with any of the following national organisations:</p><p>Registrar General’s Department Ministry of Youth, Employment and Manpower Development National Youth Council</p><p>If yes, when were you registered?</p><p>If no, have you applied for registration with any of the above?*</p><p>*Please enclose a copy letter of registration or a letter indicating you are in the process of being registered</p><p>What is the main focus of your organisation’s work?</p><p>Poverty Alleviation Education Health care Gender equality</p><p>Environment Governance HIV/AIDS Employment</p><p>Other: Describe your target group</p><p>Describe two youth outreach/peer education projects your organization has initiated*</p><p>*Please enclose copies of project reports or grant letters as well as two letters of recommendation from supervisors or others who can verify your work. If there is not enough space in this box, please continue on a separate sheet.</p><p>How were these projects funded?</p><p>How have these projects helped improve the lives/possibilities of young people in your community?</p><p>Are any groups or committees from these projects still active?</p><p>Yes No</p><p>If yes, please list below along with contact details</p><p>1. </p><p>2. </p><p>How do you expect your organisation’s involvement in this project to benefit young people and youth organisations in your community? Date Name (in block letters)</p><p>Signature*</p><p>* The signatory must be authorised by the organisation to act as a contact person </p><p>Please return the Application Form to British Council Accra, together with proof of registration and any necessary background materials as well as two applications for project participants nominated by your organisation:</p><p>Debate to Action Coordinator British Council Liberia Road P. O. Box GP771 Accra</p><p>Only successful candidates will be contacted.</p>