Sudan Women Alliance Solidarity Groups (SWAS)
Solidarity Membership Registration Form
Dear new solidarity member, welcome to SWA and please complete and return the following form to us. This is a confidential form and will help us and you identify the areas where you can best be useful, so please don’t get bored and do complete the form. New members who do not read and write will get assistance from other members. Have fun.
Name
Age Group :
16-20
20-25
25-30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
More than 70
Current country / city of residence:
Address:
Phone number:
Fax number :
E-mail addess:
Formal education:
Language(s): please indicate proficiency:
v.goodgood fairpoor
Relevant professional / work experience:
Other relevant experience:
Membership in other (women’s, human rights…etc.) organisations:
Previous memberships:
Did you read SWA’s brochure? yes no.
How did you know about SWA?
What made you join SWA Solidarity Groups?
How long have you been interested in Sudanese / African / Middle East Women’s issues?
What do you expect to learn/achieve through your solidarity membership?
What do you expect to add to SWA?
What division(s) are you interested to work in?
other (please specify):
Area(s) of interest (gender, race and social class permeate all these areas):
Are you:
an unpaid home-maker a student unemployed
employed (please specify):
self employed (please specify):
Time you can devote to SWA activities:
Most flexible time of the year / vacation:
Membership financial contribution: you will be able to contribute:
2% of your income (please specify):
minimum contribution specified by SWA office in the area:
other: please specify:
You prefer to pay membership fees every: month three months six monthsyear.
Signature of new solidarity member:
This is to certify that the above information is accurate to the best of my knowledge. I understand that providing any false information might jeopardise my membership in SWA.
Signature: Date
For SWA use only:
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