Share

DSWD-SB- PS-F-001 Application for Authority to Conduct Fund Campaign

DSWD application form to conduct fund campaign

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: As of July 31, 2014

DSWD-SB- PS-F-001: Application Form

Republic of the Philippines
Department of Social Welfare and Development
APPLICATION FOR AUTHORITY
TO CONDUCT FUND CAMPAIGN
Date: ___________________
Status of Application:
Type of Applicant:
 New Application
 Government Agency
 Renewal (pls. indicate previous issued
 Central Office
permit No. and Date) ________________
 Attached Agency
______________________________
 Regional Office
 NGO/CSO/Faith-based
Scope/Coverage:
organization
 National
 Person
 Regional (more than
1 city/municipality)
I. Identifying Information
1. Name of Person/Corporation/Organization/
Association
__________________________________
__________________________________
__________________________________

 GOCC
 State
Universities/
Colleges

2. Business Address:
_____________________________________
_____________________________________
_____________________________________
_____________________________________

3. Agency Head
_________________________________

4. Position Title/Designation
____________________________________

5. Telephone/Cell phone/Fax Numbers
_________________________________

6. E-mail Address
___________________________________

7. Registration/Permit No:
71. SEC/CDA (or other applicable Government
Registration) No:
______________________________
7.2. DSWD Registration/License No.
______________________________

8. Date of Issuance of Registration/Permit
8.1 SEC/CDA (or other applicable Government
Registration) Issued
_______________________________
8.2. DSWD Registration/License Issued
______________________________

II.

Project Proposal (Please attached accomplished DSWD-SB- PS-F-002: Project Proposal)
I hereby certify that the information on this application form is true and complete.
________________________________________________________________________
(Signature Over Printed Name of the Agency Head or Authorized Representative)

Note:

Please use additional sheet/s, if necessary.

1 of 1
 
Page of
Share