CRITERIA FOR NEW MEMBERSHIP PREAMBLE We, the Members of Africa Down Syndrome Network being committed to working together to inform, educate, and increase public awareness of Down syndrome while advocating for better services and opportunities that support and enhance the health, development and education of persons with Down syndrome and their families on the continent of Africa. The Africa Down Syndrome Network, (ADSN) encourages organisations to join our network community. Should you wish to join ADSN, please take note of the following criteria. Membership criteria For Organisations: Your organisation members must consist of persons with Down syndrome and their families. Your organisation must promote the rights of persons with Down syndrome and work towards improving the quality of life for persons with Down Syndrome, including their families. Your organisation must be registered with the relevant authorities in your country, proof of registration must accompany your application form. Your organisation must actively commit to work and participate in all activities of the network. APPLICATION FORMA. MAIN CONTACT PERSONFirst Name *Last Name *Designation *Email AddressContact NumberB. CRITERIADoes your organisation meet the criteria aboveYesNoC. ORGANISATION CONTACT INFORMATIONName of OrganisationEmailWebsiteFacebook HandleX HandleInstagram HandleLinkedIn AccountStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweD. INFORMATION ABOUT YOUR ORGANISATION: Mark Appropriate boxAre You :A Down Syndrome national organisationAn associate organisationAn intellectual disability organisationOther organisation related to people with Down syndromeIf you indicated other, please provide additional information on your work:Our area of work is :National (working across the country)Regional/Local (working in regional or local community)Do you have local groups/branches, please provide detailsAssociate organisations: Are you affiliated to a National Body, please provide details:Do you collaborate and work with other Down Syndrome organisations in your country, and/or internationally?YesNoIf Yes, please provide detailsDo you collaborate and work with other disability organisations in your country, and/or internationally?YesNoIf Yes, please provide detailsOrganisation Physical AddressAddress Line 2CityState/Region/ProvincePostal Code/Zip CodeCountryPrimary LanguageE. ORGANISATION OBJECTIVES Please provide the followingVisionMissionValuesListed activities of the organisation:E. GOVERNANCE AND MEMBERSHIPAre you registered with the relevant authorities in your countryYesNoDo you have a Constitution/Term of ReferenceYesNoOTHERIf other, please provide detailsPlease state the composition of your Board :Upload Registration CertificateChoose FileNo file chosenDelete uploaded fileUpload constitution/Terms of ServiceChoose FileNo file chosenDelete uploaded fileHTMLNOTE: Completed for will be sent to : adsn.sec@outlook.com Upon receiving completed form and supporting documentation, applications will be reviewed by the board and applicants will be notified of eligibility via email.Send Message