Annex 9 Application Form for Registration Certificate

Annex 9 APPLICATION FORM FOR REGISTRATION CERTIFICATE OF OPERATION REPRESENTATIVE/PROJECT OFFICE Concerning issuance, extension, amendment, modification of certificate 1.. Vietnamese cou

Annex 9 APPLICATION FORM FOR REGISTRATION CERTIFICATE

OF OPERATION (REPRESENTATIVE/PROJECT OFFICE) Concerning issuance, extension, amendment, modification of certificate

1 Full name of Organization:

2 Nationality:

3 Vietnamese counterpart agencies (If available):

4 Address of Headquarter: Tel: Fax: Email:

5 Mandate and Objectives:

6 Financial resources and budget:

7 Programmes, projects or plans of activities (approved by Vietnamese competent authorities in case of Rep/Project Office) in Vietnam:

8 Intended locations of operation in Vietnam:

9 Purpose for establishing rep/Project Office in Vietnam:

10.Name of Head of Rep/Project Office or the person authorized by the relevant INGO : Date of Birth: Passport No: Contact address in Vietnam (Tel, Fax, Email): 11.Number of Expatriate and Vietnamese staff proposed:

12.We are committed to strictly abide by the Vietnamese laws in force as well as Decree No 12/2012/ND-CP on registration and management

of operations of INGOs in Vietnam

Done at , date

Signature of applicant

stamp

(Full Name)