Wet-Africa.org Electronic Commitment Form

WET-Africa is dedicated to restoring the critically endangered rivers of Africa and the globe to health from source to sea. The challenge is obviously massive, but failure isn’t an option. We need a lot of help –hopefully yours!

WET-Africa has been designed specifically to become a multi-partner, collaborative ‘platform’ made up of local and global leaders who are specialists in their respective fields and who want to bring their expertise to a collaborative platform where it can be further developed and brought to scale along with the efforts of other innovative social-profit leaders. We hope we can count on you for ideas, sustained effort, and financial support – all needed to help bring South Africa’s rivers back to life while developing and modeling new methods of ‘self-motivated’ collaboration the world so desperately needs.

This commitment form will give us all a better idea of how we can work together by bringing our unique abilities to this massive challenge. When logged into the site, you can re-visit and update this commitment whenever you wish. We are delighted to welcome you as a supporter of Wet-Africa.org

Name: *

Your name

Title: *

Your title / designation

Organisation Name:

The name of your organisation / company

Profile - Which of these best describes you?: * - Select -IndividualCommunity OrganizationSmall Business ( <10 employees )Primary SchoolMedium Business ( 10 - 50 employees)High SchoolLarge business or Corporation ( > 50 )University / Learning InstituteGovernment Department or AgencyFoundationNGO / PBOInternational Multilateral AgencyDonor Organisation

email: *

Your email address for correspondence

Address: *

Your postal address

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 AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe

Your Country

Cellphone:

Your mobile telephone number - please include dialing code eg. +27-11-555-5555

Telephone:

Your landline telephone number - please include dialing code eg. +27-11-555-5555

Fax Number:

Your fax number including international dialing code eg. +27-11-555-5555

Website url:

The url of your website - please prefix with http:// eg http://www.mysite.com

Blog url:

The url of your blog - please include http:// eg http://myblog.blogspot.com

Skype username:

Mission & Passion:

Your Mission & Passion

Anticipated Membership Category: *

WET-Innovative Partner - $20,000 Int; R20,000 RSA

WET-Investor $50,000 Int; R50,000 RSA/ and up

WET-Volunteer or Individual Donor $500 Int; R500 RSA

Areas of interest: *

Project Innovation Social Entrepreneurs, organizations, business & govt. leaders with projects for the WET-Africa Platform

Financial Investment Grants or Donations to support the WET-Africa Program

Research Measuring program impacts (SEE Indicators and biodiversity) Field study–Living Lab

Academic Collaboration Knowledge-sharing, research, conferences, think-tanks, Academic Papers, M&E

Expertise Collaboration Sustainability, engineering, recycling, sanitation, business development, govt. relations & comms.

Gifts In-Kind Admin. office, communications, I.T. River restoration, recycling, environmental programming

Education & training programs Trees, grasses, plants, building material etc.

Other-Admin. help manage & coordinate the local office and organization of global Members

Project Assistance Help design/implement river & land restoration, community education & development projects

Training Assistance Expertise to develop life skills, employment skills, and professional accreditation

Reduced-rate Services Reduced-rate services in your area of expertise.

Recorders Visual & information recording: photographic, video, sound, facts, stories.

Experience:

A brief overview of your experience

SEE Objectives:

Please provide a brief synopsis of your SEE Objectives (Social, Economic and Environmental)

Commitment Description:

Please provide a brief overview of how you can assist in WET-Africa's vision of clean rivers in Africa, from source to sea.

Jukskei 67 Objectives:

Please provide a brief overview of the objectives in terms of the WET Jukskei 67 Proof-of-Concept Project that you could assist in realising

Jukskei 67 Measurable SEE Objectives:

Please provide a brief synopsis of the SEE Objectives (Social, Economic and Environmental) you could contribute to in respect of the Jukskei 67 project

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