Membership Option
Individual
Representative of an Organisation
Survivor Champion
Survivor of Sexual or Gender based Violence
Technical ParParticipant in the Faith in Action against GBV Collectivetner
Personal Information, whether you are an individual member or an organisational representative . Fields with a red * are required information.
Your Contact Details
Your Title
Mr
Ms
Dr
Ds
Past
Prof
Fr
Bishop
Rev
Your Name
First name *
Middle name
Last name *
Your Primary E-mail
Your Secondary E-mail
Province / State
By accepting I/We agree that my information may be used only for WWSOSA or "Faith Action
Against GBV information sharing and newsletters. My information will not be used in any other way.
If I submit this information as individual or organisational member: - I (as individual)/We (as
organisation) recognise the WWSOSA values, endorse the positions set out in the membership
document & commit to play an active role in the coalition. - I/We hereby acknowledge and accept
that in the event of being recorded in any way by WWSOSA or Faith Action against GBV, I/We: -
Allow WWSOSA or Faith Action against GBV to use the photograph/film/audio recording/interview
at its discretion; - Do not hold any rights to it, and I/We will receive no remuneration for the
photograph/film/recording/interview, nor have editing rights over it.
The information you shared is the minimum we need in order to share information with you. However, one of the challenges we experience when dealing with sexual- and gender-based violence is that we do not know who is doing what, and where! This often means that we work in isolation and reinvent the wheel - reducing our impact.
As faith-based organisations it would be very helpful if we could know what others are doing so that we are able to collaborate and refer those in need to the correct organisation. We might even need partners for shared proposals or responses to challenges. In order to do this, we need a more comprehensive database.
We would really value it if you can share more information in the sections below.
the first section gives a bit more information about you
if you represent an organisation, the second section provides more organisational information.
The third section provides info about the focus areas and services you or the organisation provide.
Completeting the forms will be quite quick, but very helpful!
With which sex do you identify?
Male
Female
Intersex
Prefer not to say
Your Address
Building / Unit name
Street name and number
Suburb
Province / State
Country
Postal Code
Phone Number where you can be contacted (Include country and area code)
Telephone Number
Cell phone Number
Your Faith / Religion
None
African Indigenous
B’hai
Christian
Hindu
Jewish
Muslim
Other (Please Indicate)
Organisational Details
Complete only for organisational membership
(Type none if only individual membership)
Organisation name
Organisation Website
If you are not the organisation's official representative, or if communication should also be sent to
an alternate contact person, please add details of the correct contact person
Contact Title (mark with an x
Mr
Ms
Dr
Ds
Past
Prof
Fr
Bishop
Rev
Contact Name
First name *
Middle name
Last name *
Contact Primary E-mail
Primary E-mail
Secondary E-mail
Organisational Address
Building / Unit name
Street name and number
Suburb
Province / State
Country
Postal Code
Phone Number where the organisation can be contacted (Include country and area code)
Telephone Number
Cell phone Number
Additional Information about Services you or the Organisational Provide
Areas where you or the organisation work:
International
Regional
National
Local
Community
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