Date Filed: _____________

CSO DIRECTORY

NAME OF ORGANIZATION:

HEAD OF ORGANIZATION:

CONTACT INFORMATION:
Office Address:

Mobile Number:
Fax Number:
Email Address:
Website (if any)

Organization's Objectives/ Purposes:

Services Offered: Community/ies served or currently being served:

LIST OF MEMBERS
(use additional sheet if necessary)
Name Designation Address Contact No. Gender

Information on Registration and/or Accreditation

National Government Agency:

Accreditation Number:
Date Issued:
Date of Expiration:
SOCIAL PREPARATION: (use additional sheet if necessary)
Social Issue/ Problems Proposed Program/ Project/ Activity Location Beneficiary Sector/s

Record No._______
Date Filed: _____________
CSO DIRECTORY

Signature over Printed Name of Head

LIST OF MEMBERS
Name Designation Address Contact No. Gender

Record No._______
Date Filed: _____________
CSO DIRECTORY

Record No._______