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If you are a civil society organisation and would like to be part of the Civil Society Gateway, please complete the following form. If you have any questions, please contact us.

Fields marked (*) are required fields.

Organisation name: *
Media contact name: *
Job title: *
Address: *
City: *
Country: *
Postal Code: *
Telephone: *
Fax:
Email: *
Valid email address required!
Website:
Twitter ID (If you have one):
Blog (If you have one):
RSS News feed (News feeds may be displayed on the homepage of the database - please only include if you would like your news to be included):
Organisation description (max. 200 words): *
 You are only allowed 200 words


Please identify the geographical focus of the organisation:

(Please select at least one geographical focus from the left side, specifying countries are optional)

Local level (district, city, region) within a single country Specify country: 
Single country Specify country: 
Multi-country Africa region Specify countries
(press ctrl to select multiple countries): 
Multi-country Americas Region Specify countries
(press ctrl to select multiple countries): 
Multi-country Asia Region Specify countries
(press ctrl to select multiple countries): 
Multi-country Europe Region Specify countries
(press ctrl to select multiple countries): 
Multi-country Oceania Region Specify countries
(press ctrl to select multiple countries): 
Global (multiple countries in multiple regions) Specify countries
(press ctrl to select multiple countries): 


Please identify theme(s) (and sub-theme(s) where applicable) the organization works in:
* NOTE: Please only select those themes an organisational representative is able to discuss authoritatively with the media.

(Please select at least one theme or sub-theme)

Theme Sub-theme
Arts, culture and entertainment Arts and culture
Sports
Education Early childhood care and development
Skills development
Religion
Disasters and humanitarian relief
Conflict / War / Peace / Security
Media and Communication Media/journalism/press freedom
Alternative and community media
Information Communication Technology
Science and Technology
Economy, Finance and industry Economy/Trade
Microfinance
Energy/Extractive industries
Agriculture/Farming/Fishing/Forestry
Populations Gender and Sexuality
Indigenous peoples (inc land rights)
Ethnicity/Race
Men/boys
Women/girls
Seniors
Children/Youth
Migration, refugees and trafficking Forced Migration/Refugees
Slavery/human trafficking
Development issues Poverty/MDGs
Housing
Sustainable Development
Water/Sanitation
Environment Animal Welfare/Rights
Environment/Conservation
Climate Change
Civil Society Civic Participation and Volunteerism
Civil society
Health issues Disability
Health (inc addiction, excl HIV/AIDS)
HIV/AIDS
Food/Nutrition
Governance, politics and international relations Governance and Transparency (inc local governance)
International institutions (UN, IFIs etc)
Globalisation
Accountability
Labour issues Workers rights (inc sex workers)
Justice, law and human rights Law and legal reform
Human rights and social justice


Please indicate the language(s) of communication for the organisation:

(Please select at least one language or specify your language)

English: French:
Spanish: Arabic:
Other:


Please upload the organisation's logo to be displayed along side its profile in the database.
The file size can be no larger then 20KB and the logo will be constrained within a screen area of 100 pixels (height) by 200 pixels (wide) when displayed. The image file must be one of the following formats: Jpeg, Gif or Png.

Organisation logo:
Security Code: Confirmation code
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Disclaimer
In completing and submitting this form, you authorize CIVICUS: World Alliance for Citizen Participation and Inter Press Services (IPS) to post the information contained in this form on the database as described above where it will be accessible to the general public. All reasonable precautions will be taken to protect contacts in this database from receiving spam or other unwanted forms of communication. We will not pass on the information in the form of contact lists to any third parties. However, as the database is accessible to the general public, neither CIVICUS nor IPS accept liability for any unwanted forms of communication and their results that may arise from submitting this form. CIVICUS and/or IPS may use the details in this form to send you, from time to time, information we feel may be of interest to you. At any time, should you wish to be removed from the database, please email communication(at)civicus.org.