Application Form of CSAP (Sierra Leone)

1	Information on your organization *Please explain why your organization is eligible to be a Member Organization for C-CfA.				(e.g. aim, history, membership, member organisations, activities, network, budget, human resource, etc.)
	As a Process, Platform and Forum here are our values:- Our Values System: 1.      Our vision: We believe that another Sierra Leone is possible. A Sierra Leone where all are equal before the law, corruption a thing of the past, gender equality the norm not exception, education a right and free etc. 2.      Mission: Our mission is to transform Sierra Leone into a country of dedicated citizens with values, skills, knowledge and adequate information. 3.      Our Values: We believe in the African Collective Leadership, respect for age, knowledge and the power of the people; strong resentment against corruption, gender inequality, sexual harassment, child and human trafficking, pornography etc. 4.        Note: Attached, please find the following documents relating to the Aims, history, membership, member organizations, activities, networks, pedagogy and work on HIPC/PRSP etc.
2	Name, position and contact of a person who is in charge of this commission
	Name: Mr. Falla Ensa-N’Dayma Position within the organization: National Co-ordinator e-mail address: [e-mail] Telephone:[phone]: Cell:[phone] /[phone] Fax:[phone] Skype name:fallakendeh_fen *Please attach her/his CV. Attached
	Reason why he/she is eligible to be in charge of a representative of your organization
	Mr. Ensa-N’Dayma, is a trained journalist with 30 years practice interspersed with trade unionism, community development, civil society activism, human and African peoples rights activities, agitation for PLWHA and minorities e.g. Gays etc.
3	Budget allocation for becoming a Member Organisation of C-CfA					e.g. its amount and how to be spent (in USDollar)
4	List of NGOs that recommend your organisation to represent them		*Please fill out at least 10 names of organizations. *Contact should be postal address, telephone number and e-mail address (Website URL, if there is).
	Name1	National Forum for Human Rights (NFHR)	Contact	29 Big Waterloo Street, Freetown. [phone], E-mail:[e-mail]
	Name2	Network Movement for Justice & Development (NMJD)	Contact	29 Main Motor Road, Freetown. [phone], Email: [e-mail], [e-mail]
	Name3	Trade Union Confederation of Sierra Leone (TUC-SL)	Contact	1 Regent Street, Freetown. [phone], E-mail: [e-mail]
	Name4	Coalition of Women’s Organizations – Eastern Region	Contact	1 Wesley Street, Kenema City, Eastern Region, [phone], Email: [e-mail]
	Name5	Centre for Democracy & Human Rights (CDHR)	Contact	24 Station Road, Makeni City, Northern Region, [phone], E-mail: [e-mail]
	Name6	Gender Awareness Programme (GAP)	Contact	6 Freetown Road, Moyamba Town, Southern Region. [phone]. No E-mail
	Name7	National Farmers Association of Sierra Leone (NAFSL)	Contact	2nd Floor, Old Agriculture Building, Tower Hill, Freetown. [phone], E-mail: [e-mail]
	Name8	Freetown Human Rights Committee	Contact	C/o UNIOSIL, Aberdeen, Freetown. E-mail: [e-mail]
	Name9	Campaign for Just Mining (CJM)	Contact	2 Suku Tamba Street, Koidu City, Kono District, Eastern Province, [phone]
	Name10	Vision for the Blind	Contact	24 Fort Street, Freetown. [phone], Email: [e-mail]
	Name11	Indigenous Transport Owners Association (ITOA)	Contact	140 Bai Bureh Road, Kissy, Freetown. [phone], E-mail: [e-mail]
* You may add more names of organizations if there are more organizations that are recommending your organization.

List of NGOs (The Nigerian Pro-Poor Governance Network)

4	List of NGOs that recommend your organisation to represent them		*Please fill out at least 10 names of organizations. *Contact should be postal address, telephone number and e-mail address (Website URL, if there is).
	NAME OF NGO	CONTACT PERSON	POSTAL ADDRESS	TELEPHONE NUMBER AND E-MAIL ADDRESS
	Environmental And Rural Medication Centre (ENVIRVMEDIC)	Itoghor O. Monday	No. 26, Eboh Road Warri, Delta State	[e-mail] 234-53-251732, 2348023296640; 234 8030945108
	Kwara Partnership Against Poverty	Aliyu A. Sadiq		[e-mail] 234 8033579767
	Hope for Village Child	Sister Rita	P.O. Box 3409 Kaduna	[e-mail] 234 8036696187
	UNDP	Samson Adayekun	UN House, plot 617/618 Diplomatic Zone, Central Distr. Area, Abuja.	[e-mail] 234 023452848
	YOTASCID	Yari Aduak	YOTASCID P.O. Box 58 Zonkwa	[e-mail] 234 8038068749
	Association of Women Living with HIV/AIDS in Nigeria (ASWHAN)	Doris Emmanuel Hajara Bala	No.4 Jaba Close Opp. FCT Office, Area 11 Abuja  OR 20 Aka-Itiam Road, Off Udo-Udoma Avenue Uyo Akwa Ibom	[e-mail] 234 8039114259; 234 8038068749
	CBD-NGO Forum	Rehab David	P.O. Box 13434 Jos Plateau State	[e-mail] [e-mail] 234 73 280434; 234 8037040355
	Justice Development and Peace Commission (JDPC)	Rev. F. Akinseloym	P.O. Box 400, Akure,	[e-mail] 234 8051133262; 234 8033504402
	CESODYO	M.J. Ahmadu	18A Okere/Kabba Road Lokongona Phase 1 Beside NAFDAC Office Lokoja	[e-mail] 234 8033886580 234 8055034575
	Society For Community Development	A. Apoede	P.O. Box 4339 Garki-Abuja	[e-mail] 234 8033141652
	ABANTU For Development	Ola Seyi Ayodele	P.O.Box 2604 Kaduna	[e-mail] [e-mail] 234 62-218890; 234 8038764130
	Centre For Environment, Human Rights and Development (CEHRD)	Patrick Naagbanton	6, Obo Nwanboke Street, P.O. Box 590, Ogale-Nchia, Eleme, Rivers State	[e-mail] [e-mail] 234 8033367823
	Civil Society Action Coalition on Education For All (CSACEFA)	Sarah Ochekpe	Flat 6 Doyin House beside PHCN, Wuse Zone 4 Abuja	[e-mail] 234 9 2900526
	Youth Advancement Organization of Nigeria (YAON), B/Kebbi	Haruna Alkasim	P.M. B. 1119, B/Kebbi	[e-mail] 234 8020531372
	Rev. Tor Uja	Benue SACA	C/o P.O. Box 1863, Markudi Benue State	234 8024524069
	Youth Awanreness, Advancement and Patrotic Association (YAAPA)	Abdulkarim Adamu	No. A, Isah Wasagu Road Off Sultan Abubakar Road,    GRA Sokoto	[e-mail] 234 8065119937
	Heal the Land Initiative In Nigeria (HELIN)	Kelechi Ihedimbu	No. 20 Aka Itiam Road, off Udo-Udoma Avenue, Uyo Akwa Ibom State	[e-mail] [e-mail] 234 8023350563
	Care For Life	Paulina Dogo	P.O. Box 105, Billiri, Gombe	234 8027653493
	Hope for Lonely (HFC)	Sarah Yapwa	P.O. Box 451	[e-mail]. 234 8059447785; 234 8059677330
	Centre For Creative Arts Education	Hilda Dokubo	10 Chief Ogbuga Street Ogbunabag, Port Harcourt.	[e-mail] [e-mail] 234 8036451488
	The Carpenter’s Foundation International (T-carp.Int’l)	Arc. Ibeheole, Julius	P.O. Box 12364 Garki Abuja	[e-mail] [e-mail] 234 9-7205319; 234 8033494865
	Women United For Economic Empowerment	Iniobong E. Frank	No. 70 Nwaniba Road-Ayo Akwa Ibom Street.	[e-mail] 234 805202528; 234 8027306816
	Save The World Organization (SAWOR)	John I. Ibekwe	256(94) Awka Road, (Near Mandilas Motors) Onitsha, Anambra State	[e-mail] [e-mail] 234 8033156139
	Participatory Development Alternatives	Victoria E. Eze	P.O. Box 180 Afikpo, Ebonyi State.	[e-mail] 234 8033156139
	Centre For Rural Integrations and Development	Lilian Nwokobia	4, Oheasiekwu Street, Umuagu, Asaba.	[e-mail] [e-mail] 234 8038991799; 234 8052480988
	Centre For Population And Development	Z.K.A. Bonat	12, KEFFI Road Barnawa G.R.A G. P.O. Box 7758 Kaduna.	[e-mail] [e-mail] 234 8037024794; 2348082085888
	Agape Foundation For Literacy And Rural Development	Pastor G.O. Odom  Ogazi Christopher	No. I.A. Ogoja Road Abakaliki Ebonyi State	[e-mail] [e-mail]  234 43-220519; 234 8062561771
	Applicants Welfare and National Development Centre	Ekanem Inyang	39 Kerin Lane, off Aka Road P.O. Box 1615 Uyo, Akwa Ibom Strate, Nigeria	[e-mail] [e-mail] [phone]
	Public Enlightenment Project (PEP)	Lilian Ezenwa	P.O. Box 1250 Katsina, Katsina State	[e-mail]  www.penigeria.org 234 803-5892100; 234 803-5892099
	Project Agape	David Allu	Opp. Savannah Guest Inn, Jos Road Lafia	[e-mail] [e-mail] 234 8035956554; 234 8055789482
	Educational Empowerment Initiatives Nigeria (EEIN)	Haliru A, Sadiq or Balarabe Hassan	No. A, Isah Wasagu Road Off Sultan Abubakar Road, P.M.B 2305, GRA Sokoto	[e-mail] 234 803-5892100; 234 803-5892099
	Federation of Muslem Women Association in Nigeria (FOMWAN)	Hon. Buzuwa Umar or Jamila Sani	FOMWAN Primary School Make RAR Gandu Area Birnin-Kebbi	[e-mail] 234 8038021440; 234 8020528696
	FORUM For African Women Educationalists (FAWE) Nigeria	Adelola Adegbesan	Sky-Memorial Complex, Block E, Flats 2, Wuse Zone 5 Abuja	[e-mail] [e-mail] 234 8027830082; 234 8034018944
	Nigeria Red Cross Society, Kebbi State Branch.	Ibrahim Abudullahi	Nigeria Red Cross Society Kebbi State P.O. Box 217 Gwadangaji Quarters Argogo Road B/Kebbi	[e-mail] 234 8025502565
	Youth Fate Renaissance	Borve Paago or Lebura Furubel	No. 20 Ekwe Street Mile 3, Port-Harcourt	[e-mail] 234 8037059566
	Development Exchange Centre Gombe (DEC)	J.C Makka	No. 5 Kaduna Road, Bauchi GRA P.O. Box 832 Bauchi	[e-mail] 234 8028349491
	Community Centre For Development (CCD) Sokoto	Ibrahim Adamu	P.O. Box 3851 Sokoto	[e-mail] [e-mail] 234 8035965517
	Kids and Teens Resource	Falana Martin-Mary	31,ilaje Street, Ijapo Estate, Akure, Ondo State	[e-mail] 234 8035606915
	Gender, Environment and Rural Development Initiative	Patricia Donli	1 Bama Road, Maiduguri	[e-mail]
	Keen and Care Initiative	Josephine Alabi		[e-mail] [phone]
* You may add more names of organizations if there are more organizations that are recommending your organization.

Application Form of the Nigerian Pro-Poor Governance Network (Nigeria)

1	Information on your organisation *Please explain why your organisation is eligible to be a Member Organisation for C-CfA.	(e.g. aim, history, membership, member organisations, activities, network, budget, human resource, etc.)
	Overview The Nigerian Pro-Poor Governance Network was an outcome of a one-day strategic meeting on pro-poor governance in Nigeria, held on 30 June 2005, after paper (3) presentation. The Network has over 50 member organizations (NGOs and CBOs) across Nigeria.   Vision Statement Complete extinction of poverty in Nigeria   Mission Statement To improve the standard of living for the poor and persons with disabilities (PWDs), empowering them to actively participate in transparent and accountable development of pro-poor policies, projects and programmes, budgetary formulation processes and expenditure tracking   Pro-Poor Governance Network Mandate §           Advocate, build capacity and lobby for pro-poor, gender sensitive poverty development policies, projects and programmes as well as enhance the participation of the poor and PWDs in the decision-making processes affecting their lives §           To raise funds and promote partnerships, networking and alliance building with relevant national and international stakeholders Our Strategic Focus §           The need to build a united voice of actors on pro-poor issues §           Building a critical mass movement of civil society working at local levels with shared agenda and clear purpose for social action §           Influencing pro-poor policies through strategic but constructive engagement with state and market actors §           Influence donors to adopt empowering processes and pro-poor programmes §           Engage and influence the formulation and implementation of pro-poor policies §           Facilitate exchange of ideas, information, best practices, experiences and collective social action on pro-poor issues §           To build the capacity of Pro-poor Governance Network members, partners and communities §           To conduct poverty related research that informs policy and actions
2	Name, position and contact of a person who is in charge of this commission
	Name: David Allu (Mr.) Position within the organization: National Coordinator e-mail address: [e-mail]; [e-mail] Telephone: [phone]           Fax: Skype name: *Please attach her/his CV.
	Reason why he/she is eligible to be in charge of a representative of your organization
	In the course of my development work I have pursued and strengthen dialogue and partnerships with International NGOs and Donors towards Poverty reduction. Working with Action Aid, Oxfam GB, Japanese International Development Agency, and Partners for Development programmes in different thematic areas have broaden my horizon and capacity to strategically engage Government and Donors on pro-poor and pro-civic issues. I have also attended a number of International meetings representing Nigeria or the Pro-poor Governance Network where we presented our position on issues. I do not only have a good knowledge of the dimensions of poverty in Africa, but have also been involved in using participatory as well as rights-based approaches to designing poverty eradication programmes.   I am computer literate, reliable and able to work enthusiastically under pressure, either within a team or alone. I work also in a multi-cultural environment. I am straightforward, positive, a fair person with a friendly disposition and a good sense of humour. I also possses have acquired very clear and concise written, verbal communication and presentation skills. A team player, who is analytical, independent, meticulous, resourceful and willingly to learn new things and take added responsibilities and challenges, I am positive that I would add value to  any social development work if given the opportunity to serve
3	Budget allocation for becoming a Member Organisation of C-CfA		e.g. its amount and how to be spent (in US Dollar)
	$200,000 (Two hundred thousand US Dollars) ·         Building the capacity of pro-poor Governance Network members, partners and communities ·         Conducting poverty related research that informs policy and actions ·         lobbying and advocating for pro-poor policies, projects and programmes at national and international levels ·         Promoting partnerships, networking and alliance building with relevant national and international stakeholders

Application Form of APDC (Cameroon)

1	Information on your organization *Please explain in why your organization is eligible to be a Member Organization for C-CfA.				(e.g. aim, history, membership, member organisations, activities, network, budget, human resource, etc.)
	STATISTICS AND LOCALISATION /CAMEROON: ·        location: Central Africa ·        population: about 20 millions citizens ·        area: 475 000 km² ·        youthfulness: 60% under 20 years old ·        50% in towns and 50% in rural zone ·        10 provinces (2 English-speaking and 8 French-speaking) ·        14 400 villages ·        SIDA: 5.5% in 2006.   APDC:     In 1999, considering the dangerous consequences of privatisation in the liberalisation process going on in our countries, some personalities from the Cameroonian civil society decided to create an association for the defence of consumers rights named APDC.     Formalised in august 2000, in accordance with Cameroonian law n° 90/053 of 19/12/1990 about the freedom of gathering.     APDC is non lucrative, independent, non political and religions free.   AIM: Contribute to the improvement of life conditions through the defence of consumer’s interests. Develop the regulations, the commercial practices, and consumer’s behaviour.   Method: 1-      Education and information of consumers; the purpose is to inform the consumers on their rights and obligations (seminaries, practice formulary, flyers, and other communications materials about diverse subjects of life, and a newspaper named: Le CONSOMMATEUR). 2-      Settlement amicably of conflicts, and when necessary, lawsuits. 3-      Representation of consumer’s in front of the institutions, to influence on the decisions concerning the protection of consumers. 4-      Collective actions, meetings and forums about current events when necessary.   Sphere of action:      All the problems concerning citizen’s life: economy, life quality, security, environment, health, human rights, ecology...   Partnerships:    APDC looks for partnerships with all the others associations on consumer’s field in Cameroon, Africa, the entire World.    As a poverty fighter, APDC works with all the national and international institutions with the same purposes.   Our partners: Dynamique Citoyenne Cameroon Anti Corruption youth Movement Usagers Solidaires PRODECO ACUB ANUH     NETWORK: APDC is member of several organizations ·              ANEW ·              African Water Network ·              FENAC ·              FEFAC ·              PCPA ·              CIANET ·              INTER RESEAUX ·              NAIROBI WSF ·              WATER JUSTICE   BUDGET: For 2005, USD 10 000.   Human Ressources: 02 Personalities 10 volunteer Experts volunteer/members on different fields. Members: 12 000 person.   APDC trough it’s several actions has followed plural aspects of consumer’s life: OMC conventions, ACP/UE, NEPAD, Citizenship education, VIH SIDA, Water privatisation, electricity…
2	Name, position and contact of a person who is in charge of this commission
	Name: Mr.  NKOULOU MFOULOU PARFAIT Position within the organization: EXPERT e-mail address: nkoulouparfait@yahoo,fr Telephone: [phone]               Fax: Skype name: *Please attach her/his CV.
	Reason why he/she is eligible to be in charge of a representative of your organization
3	Budget allocation for becoming a Member Organization of C-CfA					e.g. its amount and how to be spent (in US Dollar)
	Budget: USD 1 Million.   How to be spent:   Development of the network Setting up of agencies on the rest of the territory Human resources charges and information gathering Specific documentation Social mobilization.
4	List of NGOs that recommend your organization to represent them		*Please fill out at least 10 names of organizations. *Contact should be postal address, telephone number and e-mail address (Website URL, if there is).
	Name1	CGT LIBERTE	Contact	Benoît ESSIGA ([e-mail], [e-mail]) phone : [phone]
	Name2	CSP	Contact	BIKOKO J M ([e-mail]) phone: [phone]
	Name3		Contact	TSANGUEU Julienne PO Box : 6709 Yaoundé ( [e-mail] ) phone : [phone] 26
	Name4	OCOSO	Contact	TIFANG Peter ([e-mail])
	Name5	FOSCAM	Contact	MBALLA MBALLA Jean phone: [phone] 48
	Name6	PCPA	Contact	[e-mail]
	Name7	WESDE	Contact	[e-mail] phone:[phone] 39
	Name8	Dynamique Citoyenne	Contact	COUSSA Leonard [e-mail]
	Name9	LDL	Contact	Charlie TCHIKANDA [e-mail] phone:[phone] 12
	Name10	CSP-Adamaoua	Contact	MPELE phone: [phone] [e-mail]
	Name11	BASC	Contact	Leopold NAMTSAI
	Name12	RISC	Contact	BIKOKO J M phone: [phone] [e-mail]
	Name13	ACAT_littoral	Contact	Kemadjou Bertin phone:[phone] [e-mail]
	Name14	ACIC	Contact	Liman MALOUM BP.594Ydé, phone:[phone] [e-mail]
	Name15	CESAC	Contact	Louis SOMBES phone: [phone] [e-mail]
	Name16	FENASTTRA Cam	Contact	BOULA ATEBA phone: [phone] [e-mail]
	Name17	FCJ	Contact	MBELLE ABEGA J J phone:[phone] [e-mail]
	Name18	CIRCRE	Contact	SOB Anne-Marie phone:[phone] [e-mail]
	Name19	UNAPHAC	Contact	Gabriel ONDOUA phone:[phone]
	Name20	ASSOAL	Contact	Agnès METOUGOU [e-mail]
* You may add more names of organizations if there are more organizations that are recommending your organization.

Application Form of the Youth Network on MDG (Madagasdar)

1	Information on your organisation *Please explain why your organisation is eligible to be a Member Organisation for C-CfA.				(E.g. aim, history, membership, member organisations, activities, network, budget, human resource, etc.)
	The youth network on MDG (millennium development goals) was established in December 2005 during the youth national forum on employment. His aim is to implement young people to work with all actor of development of our country as a citizen to reach the MDG There are 600 youth’ associations in this network and our activities are focused around the followed theme :health and HIV/AIDS, economical and private sector, environment, sports for development, solidarity, good governance, poverty We don’t have yet our own budget but we try to advocate with united nations system in our country and they financed our activities following their priority About a human resource, we have different skills in our member: communication, manager, leader, lawyer, volunteers, consultant junior, etc.
2	Name, position and contact of a person who is in charge of this commission
	Name: Mr. Rado RAKOTOARINALA Position within the organization: National Coordinator of youth network on MDG (millennium development goals) e-mail address: [e-mail] Telephone: [phone]                           Fax: [phone] Skype name: *Please attach her/his CV.
	Reason why he/she is eligible to be in charge of a representative of your organization
	He has already represented the youth in different international meeting: In 2001 in Dakar for the 4th youth world forum of the united nations, in 2002 in New York at the session special on children, in 2003 in Kigali Rwanda at the 2nd youth pan African forum on HIV/AIDS, in 2005 in Morocco at the youth pan African summit on MDG, and last year at the global summit on MDG in New York, so he has any experiences to share and well placed to represented the civil society mainly the youth which represent more than 60% in Madagascar and he is always credible towards partners
3	Budget allocation for becoming a Member Organisation of C-CfA					e.g. its amount and how to be spent (in USDollar)
	500USD It is for the cost of telephone, internet and the meeting and transport with NGO in Madagascar for this year
4	List of NGOs that recommend your organisation to represent them		*Please fill out at least 10 names of organizations. *Contact should be postal address, telephone number and e-mail address (Website URL, if there is).
	Name1	APJM	Contact	IIC 12 Ampandrana Ouest, Antananarivo, Madagascar [phone] [e-mail]
	Name2	MAJ/FISA	Contact	23 D Ter Ambatomitsangana, Antananarivo Madagascar, tél. [phone] [e-mail]
	Name3	COM’PACT	Contact	Volosarika Ambanidia,Antananarivo Madagascar ,tél. [phone], [e-mail]
	Name4	ASU Toliara	Contact	Bloc 20Maninday BP 390 Toliara 601 SASSC,tel. [phone], [e-mail]
	Name5	Vintsy Filamatra	Contact	Bateravola Fianarantsoa, Lot 3604 IV 005 Lycée Rahenivelo Ramamonjy, tél. [phone],[e-mail]
	Name6	JEC TAMPIKRI	Contact	Lot 353 Cité Tsaramandroso Mahajanga 401, Tél.[phone], [e-mail]
	Name7	MDG network in Diego	Contact	RNM, TVM, diego, Velomanana Jean Claude, te l. [phone]
	Name8	PROJARTA	Contact	Tolotra,Lot 2A Plle 12/11 Tanamakoa 501 Toamasina,  [e-mail]
	Name9	Aina Fanilo	Contact	Lot 23 K 237 P Antananmbao Lycée Antsirabe 110, [phone],  [e-mail]
	Name10	AJMF	Contact	Lot 306 A/3702 Andavale Fianarantsoa, [phone], [e-mail]
	Name11	CLP PASIJ Reseau Majunga	Contact	Jesuelle, lgt 355 Cité Tsaramandroso, majunga 401, tél. [phone], [e-mail]
	Name12	YMCA Carion	Contact	INJ Carion MAnjakandrinana 116, Antananarivo Madagascar , [phone], [e-mail]
	Name13	MEM	Contact	Eglise Luthérien 67ha
	Name14	JIM	Contact	Bloc I N° 97 MAnjarisoa MAjunga, tel. [phone], [e-mail]
	Name15	Réseau Toamasina	Contact	Rindra, société SOMATRAFER Gare Tamatave, Tél.[phone], E.mail:[e-mail]
	Name 16	the Center Sembana Mijoro	Contact	Ms RAZAFINJATO Fela, [e-mail] 261 20 33 11 574 73
* You may add more names of organizations if there are more organizations that are recommending your organization.