Council of Corporations 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 goals of 1. Working to ensure that 175 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 end of 2015. (This would affect 875 million family members.) and 2. Working to ensure that 100 million families rise above the US$1 a day threshold adjusted for purchasing power parity (PPP), between 1990 and 2015. (This would lift half a billion people out of extreme poverty.), please list our institution as a member of the Microcredit Summit Council of Corporations.

As a member of the council we agree to:

__ Host at least one event 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 goals. (Institutional Action Plans are available on our website here.)
__ Educate our staff and customers about microcredit and the Summit's goals, using our publications and other outreach materials.
__ 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.