Sample Application Form for CSO Accreditation

Name of Organization :
Registered Address :
Contact Nos. :
Date Organized :
Date Registered :

Registering or Accrediting Agency: (Check appropriate box)

Securities and Exchange Commission
Cooperatives Development Authority
Department of Labor and Employment
Department of Social Welfare and Development
Department of Health
Department of Agriculture
Department of Agrarian Reform
Department of Education
Department of the Interior and Local Government
National Commission on Indigenous People
National Housing Authority
Insurance Commission
Philippine Regulatory Commission
Housing and Land Use Regulatory Board
Others: (Please specify)

Organizational Level: (Check appropriate box)

X Barangay-Based
Chapter
Affiliate of a larger organization (Please specify larger organization)
Others: (Please specify)

Purposes/Objectives: (Use of additional sheets, if necessary)

To construct, manage, maintain and operate adequate facilities and

services for its members; Initiate and organize socio-cultural projects and

activities to awaken community consciousness and belonging; and to promote,

enhance and foster the development and improvement of the quality of life of

the members through livelihood projects and other economic activities.

CY
Projects Costs Beneficiaries Status
Construction of steel gate members Finished
Declogging of drainage/canals members Finished
Christmas Party members Every year

Project Financing (Sources of Schemes)

Monthly Dues
Local Govt. – City of Pasig

Services the Organization provides or can participate in:

Socio cultural activities such as Christmas Parties
Livelihood programs

Depending on your organization’s technical area of expertise and scope of activity,

which local special body are you most capable to be a member of?

X Local Development Council

X Local School Board
Local Health Board
Local Peace and Order Council

List of Members: (Use separate sheet)

• Within the LGU
• Outside of the LGU, if any

WE HEREBY CERTIFY to the correctness of the above information.

Secretary

President