NGO Registration Form

Name of the NGO :

Profile of the NGO :

Address :

Pin Code :

Country :

Telephone & Fax :

Number
Email :
Website/URL

Contact Person

Name :

Mobile Number :

Registration Type Trust Society S.25 Company

(Tick whichever is applicable)

Registration No : _______________________________________________________
80G Registration No : ______________________________valid till: __________________
FCRA Registration No : _____________________________________
Registration certificate
No under section 12 A
of the IT act : _______________________________________________________
Pan : _______________________________________________________
Details of Delhi payable DD/Cheque for NGO registration fees for Rs 2000/- in
favour of Concern India Foundation

Cheque / DD Number : ______________________________________________

Cheque / DD Date : ______________________________________________

Bank : ______________________________________________

Branch : ______________________________________________

Non FCRA Account Details

Bank Name : ______________________________________________

Branch : ______________________________________________

Account No : ______________________________________________

Savings Bank Current

FCRA Account Details

Bank Name : ______________________________________________

Branch : ______________________________________________

Account No : ______________________________________________

Savings Bank Current

:
Please tick the key areas of your work from the list given below. Please do not add any new
categories.

EDUCATION MEDICAL /HEALTH RELIEF OF THE POOR

Formal Education Children Livelihood
Non Formal Education Women Capacity Building of Women
Higher Education Adolescents Others (Please Specify)
Special Education Elderly/Senior Citizens
Human Rights Aids Awareness
Vocational Training Nutrition
Environmental Education Preventive
Civic Issues Curative
Governance Animal Welfare
Disaster Management Health and Sanitation
Others(please specify) Disability
Environment related
Others (please specify)

Does your cause fall within the definition of the term “Charitable Purpose” as defined by the
Income Tax Act, 1961?

Yes No

We have read through and understood the terms and conditions governing our participation
in the Airtel Delhi half marathon 2009 and we agree to abide by the same.

Sign : ________________________________

Name : ________________________________ NGO Seal:

Designation : ________________________________
Date : ________________________________
Documents Required
Please attach the photocopies of following documents self attested by CEO/Trustee/Executive
Director

•Certificate of registration of the NGO. (as a trust/society/S.25 company)

•Section 12A registration certificate under the Income Tax Act,1961.
•Section 80G exemption certificate under the Income tax act,1961/application for renewal.
•FCRA Registration Certificate (if available) front and back.
•Address Proof such as electricity or telephone bill.
•Latest Audited Annual Financial Statements including Auditor’s report.
•Delhi Payable Cheque/DD for Rs 2000/- favouring “Concern India Foundation”. Please
note all outstation cheques will be returned.

Terms & Conditions:

•All terms and conditions that apply to participation in the Airtel Delhi Half Marathon 2009, as
indicated in the application form for the event shall apply.
•At no time will registered NGO’s , For Airtel Delhi Half Marathon2009, try to develop new
packages that would be detrimental in the fundraising efforts of other NGOs. All packages need
to be approved by the Concern India Foundation team in advance.
•Concern India Foundation retains a nominal charge on all the pledges raised, to provide
support mentioned in the process note. The fee structure is given in the process note.

Contact
Concern India Foundation
A - 52 Amar Colony, Lajpat Nagar IV, New Delhi 110 024.
Telephone : (9511) 26210997 / 26210998 / 26224482 / (011) 41622511
Telefax : (011) 41622512
Email : delhi@concernindia.org / marathon@concernindia.org