Organization Name*

Type of partner you’d like to sign up as*

DonorImplementerChampion

Go to www.nigeriacookstoves.org for details of the various categories

Name (surname first)*

Email*

Street 1*

Street 2

City/State*

Country*

AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe

Phone

Yes, I would like to receive postal mail from the Alliance

Organization Information

Organization Type*

GovernmentNon Governmental organizationPrivate sectorBilateral and multilateralCarbon project developmentAcademiaIndependent consultantOther organization type

Fuels and technologies (you can tick more than one)*

Alcohol FuelsBiogasBiomassCoalKeroseneLiquid Petroleum GasN/A (technology neutral)SolarOther

Sectors of experience and expertise (you can tick more than one)*

AgricultureBehavior ChangeFinancial/BankingForestryGenderCarbon FinanceEducationHealthInfrastructureRenewable EnergyEnergyEnvironmentRural DevelopmentSmall BusinessOther

Please briefly explain the primary sectors that most closely represent your organization's experience and expertise*

(Maximum 5 rows of text)

Mission/summary:
Please provide one or two paragraphs describing your organization's mission, and its work and/or interest in clean cookstoves and fuels. Please include details on any initiatives underway to reduce exposure to indoor air pollution, and your respective goals and successes to date*

Initiatives/targets/scale:
Please provide details on any initiatives underway, including countries, characteristics of your target populations (urban/rural, socio-economic status) and the scale of the initiatives (community/state/national/international level) and the nature and scope of the intervention*

(Maximum 5 rows of text)

Social/Cultural barriers:
Please comment on your experience and/or interest in social/cultural barriers to using traditional fuels and stoves*

(Maximum 5 rows of text)

Market development:
Please briefly describe how your organization would like to participate in the partnership, including how your organization can contribute (e.g. experience, skills, etc.).

(Maximum 5 rows of text)

Publications:
Please list any attachments you would like to include as part of your application here and email them to info@nigeriacleancooking.org

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