Membership form for organisations

1. Organisation details

Full name of the applying organisation (followed by acronym in brackets if any) *

Street *

Number *

Postal code *

City *

Country *

Telephone (+ international code) *

Website

Organisation representative

Person responsible to represent your organisation as a primary contact in its official dealings with the Platform for Intercultural Europe (e.g. General Assembly, official notifications, etc.)

First name *

Last name (capital letters please) *

Position in the organisation *

E-mail address *

Contact information

Person in charge of general contact with the Platform (if different from previous)

First name

Last name (capital letters please)

Position in the organisation

E-mail address

3. Your organisation and ICD

Describe how your organisation relates to Intercultural Dialogue and Europe

What is your organisation's mission statement ? *

200 words maximum

Which other European networks, if any, does your organisation belongs to ?

In what way, if any, do you collaborate with organisations in other European countries ?

100 words maximum

What is your interest in/involvement, if any, with European political/ European Union matters ?

100 words maximum

How did you hear about the Platform for Intercultural Europe ? *

100 words maximum

What motivates you to join the Platform for Intercultural Europe ? *

200 words maximum

4. Confirmation

Submission of this form will constitute a binding signature

I hereby declare that my organisation wishes to become a full member of the Platform for Intercultural Europe

We explicitly endorse the Platform’s role vis-à-vis the European Union

We hereby subscribe to the platform’s statutes

Our organisation supports the Platform's manifesto The Rainbow Paper. Intercultural Dialogue - From Practice to Policy and Back. (Support requires on-line signature on http://rainbowpaper.labforculture.org/signup/public/signup)

We agree to pay the membership fee of currently 150€ per calendar year (subject to review by the Annual General Assembly)

The data collected in this form will only be used for the purposes of the Platform for Intercultural Europe. Upon approval of your application, your contact details

might be transmitted to third parties in the context of the Platform's collaboration with them or
for their use in correspondence with the Platform's mission and objectives

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