IUCN COMMISION ON ENVIRONMENTAL ECONOMIC AND SOCIAL POLICY MEMBERSHIP

COMMISION ON HUMAN RIGHTS YAN CHRISTIAN WARINUSSY SUBCOMMISION
IUCN COMMISION ON ENVIRONMENTAL ECONOMIC AND SOCIAL POLICY MEMBERSHIP
s Ecurities and Exchange Commision sec Form 36ar Annual

MEMBERSHIP APPLICATION FORM

IUCN COMMISION

ENVIRONMENTAL, ECONOMIC AND SOCIAL POLICY

MEMBERSHIP APPLICATION FORM

2009 - 2012

Please enter details clearly in the right hand column..

Title
Family name
First name
Gender
Nationality
Address
(street address)
(street address)
PO Box
City
Postal Code
Region/Province/State
Country
Email Address
Professional Position
Organisation Name
Organisation Address
(street address)
(street address)
PO Box
City
Postal Code
Region/Province/State
Country

Which Theme or Specialist Group are you interested to join?

Please Select NO MORE THAN TWO Themes or Specialist Groups to join.

THEMES

	Theme on Culture and Conservation (TCC)
	Theme on Environment, Conflict and Security (TECS)
	Theme on Environment, Macroeconomics, Trade and Investment (TEMTI)
	Theme on Governance, Equity and Rights (TGER)
	Theme on Social and Environmental Accountability of the Private Sector (TSEAPRISE)
	Theme on Sustainable Livelihoods (TSL)

JOINT COMMISSION SPECIALIST GROUPS/THEMES

	CEESP/WCPA Theme on Indigenous Peoples, Local Communities, Equity and Protected Areas (TILCEPA)
	CEESP/SSC Sustainable Use Specialist Group (SUSG)
	CEESP/CEL Specialist Group on Indigenous Peoples, Customary & Environmental Laws & Human Rights (SPICEH)

You will find more information on CEESP Themes, and Joint Commission Specialist Groups on www.iucn.org/ceesp

Which is your preferred geographic region of affiliation where you have had the most working experience? Please tick one region below.

	GEOGRAPHIC REGION
	Africa
	East Europe, North & Central Asia
	Meso & South America
	North America & Caribbean
	Oceania
	South & East Asia
	West Asia
	West Europe

How did you hear about CEESP? Tick below.

	CEESP Newsletter
	CEESP Website
	CEESP publications
	Recommended by IUCN staff
	Recommended by existing CEESP member(s)
	Other: please specify …

Name of two existing CEESP Members who support this application:

Name:

Theme:

Name:

Theme:

Are you interested in joining the CEESP Facebook Group?

YES NO

If yes, please provide your Facebook Name.

A new CEESP Youth Network is being established of CEESP Youth Members who are between 19 – 35 years of age. Are you in this age category?

YES NO

I accept the invitation to serve as a voluntary member of the IUCN Commission on Environment, Economic and Social Policy. As a member of this Commission I am willing to volunteer my time and services and actively contribute to Commission activities and discussions to advance the Vision and Mandate of CEESP.

Signature: ____________________ Date: ________/________/________

Thank you for taking the time to fill in this form. Please send this completed application form together with a copy of your short CV to:

Elizabeth Erasito

Executive Officer, CEESP

PO Box 2089, Govt. Bldgs, Suva, FIJI

Tel:+679 3301807 , Fax: +679 3305092 , Email: [email protected]

……………………………………………………………………………………………………

FOR EO USE ONLY

Approved Yes No

Date Entered KN

Date Forwarded to Theme Co-Chair

Date Entered into INDABA

IUCN Commission on Environmental, Economic and Social Policy (CEESP)

http://www.iucn.org/ceesp

Email to: [email protected]

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