International Association of Official Human Rights

Sign-up Now! IAOHRA Member Listserv

Please print and fax the the following information to IAOHRA at (202) 624-8185.
Name of Applicant Agency:
Street address:
City:
State/Province:
Zip/Postal code:
Phone:
Fax:
E-mail:
URL:
Name of Chief Staff Officer:
Title:
Policy Body:
Date of Appointment:
Number of Members:

PLEASE ATTACH LIST OF MEMBERS AND SENIOR STAFF OFFICIALS

Head of Policy Body:

Geographic Jurisdiction (City/State):

Population Size:

Number of Staff:

Budget for Current Fiscal Year:

Law/Statute Creating Agency:

Please Attach Statute

Date of Agency's Creation:

I certify that the above agency is an agency or official organ of government 
created by constitutional authority, statute, ordinance or executive order, 
for purposes of investigating and/or granting relief for violations of human rights 
or discriminatory acts or practices; enforcing human/civil rights regulations, orders, 
recommendations or conclusions; or conducting related activities such as community 
relations programs or human rights education/training.  I further certify that upon 
acceptance as a member, the above named agency accepts and agrees to comply 
with the purposes of IAOHRA; pay dues and submit reports in a timely manner.

Signature of Agency Representative:

Date: