helprapevictim.org

My Organization has studied the Socoodeife Platform and Constitution and hereby confirms that it accepts and embraces them. (Please check both boxes below)

We confirm to have read it

User Agreement

We agree and embrace it  (PLEASE CLICK HERE TO READ IT)

My Organization hereby applies for membership in Socoodeife for

Full Membership
Associate Membership

What is the name of your Organization in your mother tongue?

Name of your Organization: Official English Translation

What year was your Organization founded?

In which country is your Organization’s head office located?

Official Street Address Line 1

Address Line 2

City

State/Province/Region

Zip/Postal Code

Country

Email

Which other countries does your Organization operate (if applicable)?

Name of Official Representative

Representative’s Position in the Organization

Email

Mobile Phone

Landline Phone

Alternate Contact Person in the Organization

Alternate Contact Person’s Position in the Organization

Email

Mobile Phone

Landline Phone

Organization’s Website

Organization’s Blog Page (if applicable)

Social Media Channels (Twitter, Facebook, Instagram, Pinterest, YouTube, Vimeo, other)

What is the total number of members in your Organization for the current year?

Does your Organization promote a lifestyle free from alcohol and other drugs?

Yes
No

Do you require your members to make a Pledge to live free from alcohol and drugs?

Yes
No

What are the main activities your Organization runs (advocacy, prevention, rehabilitation and treatment, community, development, human rights promotion etc.)?

Please write any other relevant information you wish us to know about your Organization

Please select below as many as you are interested in and we will make sure to involve you in all the action

Prevention of abuses against WOMEN

Assisting in projects to help WOMEN recover from the effects of abuse

Prevention of abuses against CHILDREN

Assisting in projects to help CHILDREN recover from the effects of abuse

Today’s date (Day/Month/Year)

User Agreement

By submitting this form, you confirm that you have read and understood the Socoodeife Mission, Vision, Core Values and Principles and your Organization agrees to uphold them to the best of your ability. (PLEASE CLICK HERE TO READ IT)