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Complaints Form
Form Type :
Complaints Form
Feedback Form
Name :
Father's Name :
Email
*
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Phone :
CNIC #
*
:
Address :
Division :
Select Division
Hyderabad
Karachi
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Larkana
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Shaheed Benazirabad
District :
Select District
Complaint Department :
Select Department
Solicitor Department
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Complaint File
(Max 2 MB)
:
Complaint
*
:
Character Limit is
250
Suggestion For Complaint :
Character Limit is
250
Disclaimer :
I agree
01
Basic Details of Organization
Abbreviation / Acronym
(in applicable)
Full Name of Organization
Type of Organization:
(tick as appropriate)
Pakistani NGO
International NGO
Corporate Firm
Pakistani Charity Organization
Nature of Organization Work / Services:
(tick as appropriate)
Socio-Economic Development & Empowerment
Humanitarian Work
Service Delivery / Project Implementation
Research and Advocacy
Capacity Building / Institutional Development
Rescue Operations
Human Rights
Academic Institution
Network / Consortium / Alliance
CSR
02 (A)
Legal Status
(for Pakistani Organizations Only)
Details of Organization Registration
#
Registration Authority / Law
Date of Reg.
Reg. Number
1
The Societies Registration Act, 1860
2
The Trust Act, 1882
3
The Voluntary Social Welfare Agencies Ordinance, 1961
4
The Companies Ordinance, 1984
(Non-Profit Company, Section 42)
5
Other – Specify
02 (B)
Legal Status
(for International Organizations Only)
i - Registration Details in Pakistan
1
Registration Authority / Law
2
Date of Registration
3
Registration Number
ii - Registration Details at Head Quarters
1
Country of Origin / Head Quarters
2
Registration Authority / Law
3
Date of Registration
4
Registration Number
03
Organization Human Resources
i - Details of foreign nationals working in the NGO/INGOs:
S No.
Name
Nationality
Copy of Passport
Address in the Home Country
Telephone number in Home Country
Address in Pakistan
1
2
ii - Details of Locals working in NGO/INGOs:
S No.
Name
Father Name
CNIC Number
Complete Address (Permanent)
Complete Address (Temporary)
Telephone Number
1
2
iii - Details of Volunteers:
#
District
Male
Femal
Total
1
2
3
4
Total Volunteers
04
Goal / Vision / Mission
i - Goal / Vision Statement
(if applicable)
i – Mission Statement
(if applicable)
iii - Objectives
(if applicable)
05
Thematic Focus & Projects
i - Details of Organization Thematic AreasTick appropriate
Food
Health
Nutrition
Education
Logistics
Protection
Agriculture
Early Recovery
Emergency Shelter
Water, Sanitation and Hygiene
Camp Coordination
Any other (please specify)
- Details of Current / Ongoing Projects:
#
Project Title
Sector / Focus
District(s)
UCs
# of Villages
Partner (s) *
Project Budget (PKR)
Closing Date
Funding Agency
* Pakistani Org. should mention donor name here / Int Org. should mention implementing partner name here
06
Disasters / Emergencies
i - Emergencies / Disasters Responded:
(during last 10 years only)
#
Year
Type of Emergency / Disaster
Province
District (s) of Intervention
1
2
3
4
ii - Priority Districts of Sindh Province for Disaster Response: (if any in future)
iii–Available Stocks / Resources
#
Type of Resources / Stocks / Equipment / Materials Available or Can Instantly Be Mobilized By Organization
Qty
Location
Remarks
1
2
3
07
Memberships / Affiliations
i - Details of Memberships & Affiliations with Networks / Forums:
#
Name of Network or Forum
Membership / Joining Date
1
National Humanitarian Network (NHN)
2
Pakistan Humanitarian Network (PHF)
3
Others – specify
4
Others – specify
08
Addresses / Contacts & Contact Persons
i - Contacts
(Main Office / Head Office)
Type of Office
Mailing Address
City
Phone
(landline)
Phone
(cell number)
Fax
Email
Website
Facebook
ii - Contacts
(Sindh Province Main Office)
Type of Office
Mailing Address
City
Phone
(landline)
Phone
(cell number)
Fax
Email
iii - Contact Persons for PDMA (at least 2):
#
Name of Staff
Title / Designation
Cell Number
E-mail
1
2
v - Contacts for E.mail& SMS Emergency Alert from PDMA
Cell-I
Cell-II
E.mail-I
E.mail-II
Disclaimer
I agree