About you
First Name:
Last Name:
Job Title:
Name of organisation:
Address of Organisation:
Contact Number:
Gender:
E-mail address:
Of the four regions available for sponsorship please indicate in which region your work is based:
Which of the following best describes your experience/area of expertise relevant to the CIF programme priorities? If none of the below apply, please use the 'other' box to provide us with more information about your experience/expertise:
Please give details
Experience / Area of Expertise
Describe how your expertise and how your work activities relate to the area of expertise that you cited in the above question? i.e: How does your work/projects relate to the CIF programme areas? How long have you specialised in the above area(s)? Has that involvement been at the local, national or international level?:
Please give examples of how your organisation has a track record of mobilising capital towards reducing emissions, fostering sustainability or other climate related activities:
Is your organisation interested in engaging with the CIF pilot programmes in a financial or a technical capacity?:
Please indicate if you / your organisation has a demonstrated affiliation with a community affected by the work of the CIF committees or experience / high level of understanding of the CIF pilot programmes. If so, please provide details and indicate which countries/regions below:
Please indicate if you / your organisation is part of a wider network or stakeholder group i.e. works in a network of other organisations on a local, national, regional or international network:
Please provide the name and details of a referee from the organisation you represent, to verify expertise and experience:
Job Title (referee):
Organisation (referee):
Contact Number (referee):
Email address (referee):
Relationship to referee:
Do you / your organisation have any current, past or pending contractual or direct financial relationships with the World Bank? Please provide details below:
Language
Please indicate which of the following languages you believe you have a sufficient understanding, in order to take part effectively in formal sessions of the Partnership Forum and pilot country meetings. You may check more than one box if applicable:
Register your interest in becoming a CIF Observer
Would you like to register your interest in becoming an Observer to the CIF decision-making committees for the 2011-2013 period?:
If you are not selected for sponsorship to attend the CIF 2011 Partnership Forum, would you be interested in self-funding to attend the CIF Forum? (N.B Spaces for self-sponsored attendees are limited)
