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Application Form

The members of the Microinsurance Network are committed to actively contribute to the creation of public goods with the aim to promote the development of good value insurance services for low-income persons.

APPLICANT INFORMATION

Title

First name

Last name

Job title

Address

City

Post code

Country

E-mail

Telephone

Fax

 

ORGANISATION INFORMATION

Full name

Short name

Address

City

Post code

Country

Website

What type of organisation do you work for?

 

If other, please specify:

 
 

Mission statement (No more than 600 words)

Is your organisation already an institutional member of the Network?

Yes No

If yes, please jump directly to the section WORKING GROUP PARTICIPATION

 

INFORMATION ON MICROINSURANCE ACTIVITIES

What areas of expertise is your organisation (are you) involved in?

Advisory services and technical assistance

Audit

Capacity building/Training

Consumer protection

Distribution

Donor policy

Impact study

Information dissemination

Insurance education

Management Information System (MIS)

Market study

Policy advocacy

Project evaluation

Product development

Regulation and supervision

Research

Other

If other, please specify:

 
 

What type of insurance product(s) does your organisation (do you) focus on?

None

Agriculture

Credit

Health

Life

Livestock

Natural disaster

Property

Other

If other, please specify:

 
 

In which region(s) do you carry out your microinsurance activities?

None

Europe and Central Asia

East Asia and Pacific

South Asia

Latin America and the Caribbean

North America

Sub-Saharan Africa

Middle East and North Africa

Comments:

 

Does your organisation have a separate microinsurance department or full-time staff working on microinsurance?

 

What is your organisation’s annual budget for microinsurance?

 
 

Is your organisation involved in any activities apart from microinsurance?

Yes No

If yes, please briefly describe them (no more than 300 words):

 

WORKING GROUP PARTICIPATION

Members who would like to join a Working or Discussion Group should actively contribute to the group by drawing on their expertise to enrich and advance the work being carried out. This contribution can either be in-kind or financial. If you do not have sufficient time available at the moment to be active in a group, you can easily join at a later stage.

Visit the Working Group pages to learn more about their activities.

Please select the Working/Discussion Group that you want to contribute to, if any.

 
 

Why and how will you contribute to the selected Working/Discussion Group?

 

MEMBERSHIP FEES

Institutional membership
The Network’s institutional membership fee structure is based on an honour system and organisations are asked to classify themselves. To learn more about the Membership fee categories, click here

750,- EUR (Small institutional membership)
1 500,- EUR (Medium institutional membership)
2 500,- EUR (Large institutional membership)

My organisation is already a member and therefore,
       I do not need to select a fee.

 

Individual membership

200,- EUR

Note: Due to the high rate of outstanding individual applications, the Network requests that prospective individual members pay their 200,- EUR membership fee in advance. Once we receive your application and CV, we will contact you with payment details. If your application is not validated, we will provide you with a full refund.

Click here to send your CV.

 

JOINING THE NETWORK

Why do you want to join the Microinsurance Network?

In which way would you like to contribute to the Network's activities (for example, participation to the Working Groups, annual meetings, research, writing, training design, the General Assembly.)?

How did you hear about the Microinsurance Network?

Please indicate whether you have an affiliation with another member of the Microinsurance Network, and if so who? Please note that this organisation should be able to vouch for you.

What do you expect from being a member of the Network?

Let us know if you have any further questions.

   

I confirm that I have read and understood the Microinsurance Network’s Bylaws

Please note that only complete applications will be considered.
The operational language of the Network is English and all exchange is carried out in this language.

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