Internship Name Mother’s Name Birth Day Sex Male Female Blood Group Address City State Country Nationality Postal Code E-mail Telephone (Res): Qualification Attach All Documents Profession Has the candidate previously been the member of the GIMC Organization? Yes No Is the candidate a member of, or previously been a member of any other non-profit organization? Yes No Has the candidate been involved with any social activities in the past? Yes No Preferences of the candidate for the Kind of Work he/she would like to get involved with GIMC Organization Types of Membership Volunteer Membership (Fee $.120/-for one year) General Membership (Fee $.5,000/-for one year) Executive Membership (Fee $.10,000/- for one year) Any Donation / Contribution in Cash or Kind Passport/Driver’s License/ No Criminal Record Certificate Two passport size photographs with signature on the back of second photo Place Date Signature of. The Candidate Witness Name Address Phone Cell Profession Signature Date The Witness I, wish to become a member of Global Initiative for Minorities and Children (GIMC) We work for a somalia where minority communities and children enjoy equal rights,protection,quality services and opportunities to reach their full potential. Become a Volunteer
