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Nov 05, 2008

We are happy to place below the membership application form and procedure to become members of the ICA.




INTERNATIONAL Route des Morillons 15 Tel: (41 22) 929 88 38
CO-OPERATIVE 1218 Grand-Saconnex Fax: (41 22) 798 41 22
ALLIANCE Geneva E-mail: ica@ica.coop
Switzerland Website: www.ica.coop



ICA MEMBERSHIP APPLICATION FORM 2008 - NEW
1. Contact Information

Organisation’s Name: _________________________________________________________
Acronym: __________________________________________________________________
Address: ___________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Telephone: _____________________________ Fax: ________________________________
(country code-city code-number)
E-mail: ______________________________ Website: ______________________________
Skype or MSN address: ________________________________________________________
President: _________________________________
Contact Person, if different from the President (name and title): ________________________
___________________________________________________________________________
Contact Person Email: ____________________________ Telephone: ___________________
2. Organisation Information

Description of your organisation: ________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Date founded: ____________________________________
(day, month, year)
What are the aims of your organisation? __________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________


Does your organisation adhere to and/or support the Co-operative Identity Statement?
? yes ? no ? comment______________________________________________________

What are your sectors of activity?

? Agriculture / Forestry
? Consumer / Retail
? Banking / Credit Unions
? Insurance
? Health
? Tourism
? Fisheries
? Housing
? Workers / Industrial
? Independent retailers
? Utilities
? Social
? Other: ________________________________

3. Why are you interested in ICA membership?

Please indicate why you wish to become a member of the ICA? Please rate in order of importance.

___ Act in solidarity with the co-operative movement
___ Participate in co-operative activities at the regional level
___ Participate in co-operative activities at the sectoral level
___ Participate in co-operative activities at the thematic level
___ Be represented and defended by ICA in case of conflict or dispute with your countries public authorities or with regional or international institutions.
___ Elect and be eligible for ICA leadership positions
___ Participate in various ICA events
___ Develop business relationships and partnerships with other ICA member organisations. Access co-operative contacts.
___ Gain access to ICA as a centre of co-operative expertise, in particular co-operative statistics, information and intelligence.
___ Utilise the capacity of the ICA to increase the global, regional and sectoral influence of co-operatives
___ Contribute to the work programme of the ICA
___ Be eligible to purchase and use a .coop domain name which will demonstrate your co-operative identity.
___ Participate in training programmes
___ Receive and benefit from communications materials
___ Access development support
___ Other: ________________________________


What do you expect from the ICA? ______________________________________________
___________________________________________________________________________
___________________________________________________________________________


How did you find out about the ICA?

? ICA Websites. Please indicate which one:
_____________________________________
? ICA Digest
? ICA Central Office
? ICA Regional Office
? ICA Sectoral Organisation
? ICA member
? Meeting or Conference
? ICA publications (please choose):
O ICA Digest
O ICA Regional Publication
O Other _____________________________
? Other. Please indicate:
_________________________________________

4. Membership status

Please check which type of membership you are applying for:
? Member (full members with voting rights)
Please indicate which best describes your organization:
? National union or federation of co-operative organisations
? National confederation of co-operative unions (apex organisations)
? National co-operative business organisation with majority individual ownership
? Individual co-operative organisation (primary or grassroots co-operatives)
or ? Associate Member
Please indicate which best describes your organization:
? Organisation owned and controlled by co-operatives
? Educational, research or other institution which promotes or finances co-operatives and the co-
operative movement
? International and regional (supranational) federation or union of co-operative organisations
? Organisation which supports co-operatives
? Organisation entitled to full member status, but that is not ready to apply for full membership.
5. Annual Subscription to the ICA

Member: ICA calculates Member subscriptions on the basis of the number of individual members of their cooperatives that they have or represent, as well as affiliations to other ICA members (“members of members”). Therefore, please provide us with the number of individual persons which you and/or your member societies represented in 2007:

Number of Members in 2007: ________________

Associate Member: ICA calculates Associate Member subscriptions based on a series of flat rates.

Please list the organisations which you are a member of. Use additional sheets if necessary:
___________________________________________________________________________
___________________________________________________________________________

6. Other Statistical Information for all applicants

Total number of employees: _______________
Total number of women employees (if available): ____________

Please provide information regarding the significance of your organisation economically or socially (for example market share, awards received, etc): ___________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
7. Required Documents

Please submit the following documents with your application form:

? Rules of the Organisation
? Annual Report
? List of member societies /affiliates

We would also appreciate the following additional information:

? Historical Background
? Balance Sheet
? Statistics
? Periodicals, Audio Visuals, etc.

8. Signatory of the Applying Organisation

Name: ___________________________________________
Position: _________________________________________
Signature: ________________________________________ Date: _____________________

New Member Application Procedure






Processing Board Decision