31 January 2014

AGAPE COMPASSIONATE FUND

This is an entry point for individuals, groups, association, alumni and friends of Agape Counseling and Training Services to support the programs there in. Members can come in as ordinary members, associate members, and corporate members and alumni members, through being stake holders, special interest groups or consumers of the programs.  
A.        MEMBERSHIP LEVELS
ORDINARY MEMBER
These members participate in the funding and running of the programs once in a while. They choose programs they would wish to be involved in and can give their contributions once in a year. 
ASSOCIATE MEMBERS
These members participate by regular basis. They choose programs and decide on a format of funding, which could be monthly, quarterly, or yearly.
CORPORATE MEMBERS
These are groups or organizations that wish to work with agape counseling and training services. They choose a number of programs and activities that they want to fund, partner and collaborate in their running. Their contributions should be consistent as they will be key partners.
ALUMNI MEMBERS
These are former beneficiaries of the agape counseling and training services programs and would wish to be involved in the funding and running of the same programs, or any others of their choice.
 The table below shows the various categories explained above. Choose carefully and tick in the boxes any membership level that suits you.

MEMBERSHIP
CONTRIBUTIONS
MONTHLY
QUARTERLY
YEARLY.
AMOUNT
EFFECTIVE DATE
ALUMNI MEMBER






ORDINARY MEMBER






ASSOCIATE MEMBER






CORPORATE MEMBER






 









 
A.                    PROGRAMS
The following table shows the programs that currently are running. Please read them carefully and choose the program (s) that you desire to be involved with.

PROGRAMS
PLEASE TICK HERE
1.       
Girl Child Advocacy And Sanitary Towel Project

2.       
Youth Empowerment
Peer Counseling

Reproductive Health

3.       
 HIV Testing And Counseling Services

4.       
Orphan Support Project

5.       
Administrative Support

6.       
Marriage Nourishment

7.       
Loss, Grief & Bereavement Support

 

B.                 MEMBERS DETAILS.
The following personal details would be needed in the agape compassionate fund database.
                                i.            INDIVIDUAL MEMBERS
NAME: ………………………………………………………………………………………………………
(SURNAME)                                                           (MIDDLE NAME)                                                   (FIRST NAME)


GENDER:  (Please Tick)                         o    MALE                             o  FEMALE

NATIONALITY: …………………………………………………………………………………..

POSTAL ADDRESS: ………………………………………………...……………………………

EMAIL ADDRESS: ………………………………………………………………………………

TELEPHONE CONTACTS: …………………………………………...………………………
                              ii.            CORPORATE MEMBERS (Groups, Organizations, Associations etc)
              NAME: ………………………………………………………………………………
POSTAL ADDRESS: ………………………………………...………………………
PHYSICAL ADDRESS: ……………………………………………………..………
EMAIL ADDRESS: …………………………………………………………………
WEBSITE: …………………………………………………………………………


C.                 ADDITIONAL INFORMATION
                                i.            How did you come to know about Agape Counseling and Training Services? (Please Tick)
o    BANNER          
o    WALK IN  
o    FRIEND/ORAL
o    WEBSITE 
o    GOOGLE SEARCH             
o    BLOG SITE           
                                                    o    POSTCARD/ MAILING        


                              ii.            How will you submit your contributions? (Please Tick)


o   CASH 
o   BANKERS CHEQUE  
o   MPESA  
o   WESTERN UNION
 

D.                 COMMITMENTS

I/We agree to be a member/members of Agape Counselling & Training Services and to participate in the program identified above by faithfully paying the above and give my/our  contribution amounting to………………….
SIGNED………………………………                           DATE…………………………

E.                 FOR OFFICIAL USE.
DATE RECEIVED................................. MEMBERSHIP NO…………………………
APROVED BY:
B.O.M CHAIRMAN……………………………........   SIGN………………     DATE……..........
B.O.M SEC…………………………………………      SIGN………………     DATE……..........
VIDE B.O.M COMMITTEE MINUTE NO………….............................…….  DATED……............


 

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