Working to ensure that 100 million of the world's poorest families, especially the women of those families, are receiving credit for self-employment and other financial and business services by the year 2005.

Council of Foundations and Philanthropists Membership Form
Note: Please copy the following text into your e-mail program, fill in all necessary information, and send by e-mail to info@microcreditsummit.org. You can also print out the form, complete it by hand and fax it to us at 1-202-637-3566.

As an expression of our support for the Microcredit Summit goal of working to ensure that 100 million of the world's poorest families, especially the women of those families, are receiving credit for self-employment and other financial and business services by 2005, please list our institution as a member of the Microcredit Summit Council of Foundations and Philanthropists.

As a member of the council we agree to:

__ Host at least one briefing introducing the Microcredit Summit Campaign to our staff.
__ Announce within one year of joining this Council, our institution's action plan for contributing to the fulfillment of the Summit's goal. (Institutional Action Plans are available on our website here.)
__ Educate individuals, organizations, and our staff about microcredit and the Summit's goal, using our publications and other outreach materials.
__ Consider a grant to help fund the Microcredit Summit Campaign.
__ Have one or more of our staff visit a microcredit program within the next twelve months.

Name of Institution (as you wish to be listed):   ____________________________________
Name & Title of Head of Institution:   ____________________________________
Address:   ____________________________________
City:   ____________________________________
State/Province:   ____________________________________
Zip/Postal Code:   ____________________________________
Country:   ____________________________________
Telephone Number (with country & city codes):   ____________________________________
Fax number:   ____________________________________
E-mail address:   ____________________________________
Name & Title of Person Authorizing Endorsement:   ____________________________________
Your Institution's Contact Person:   ____________________________________
Name of Newsletter/Magazine Editor:   ____________________________________
 

Please click here to download an Institutional Action Plan for this Council.