A. CONTACT INFORMATION

(REQUIRED FOR ALL CATEGORIES)

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What is your preferred method of receiving any communication from Response USA?

B. VOLUNTEER

C. CHANGE MAKER

Are you willing to pledge that:

YOU will NEVER commit violence against women and girls
YOU will NEVER condone the violence against women and girls committed by anybody in your family, peers and community
YOU will publicly condemn the heinous practices of violence against women and girls including the so called practice of ‘honor killing’- the worst form of VAW
YOU will raise awareness among your family members, peers and community on women rights and implications of violence against women and girls and motivate at least 10 individuals to become Change Makers

D. EMERGENCY RESPONSE TEAM

Ability and willingness to travel

Have you ever attended any training on humanitarian response operations?

E. ORGANIZE EVENT FOR RESPONSE USA

Please elaborate

Do you need a speaker for the event?