Membership Application 2020

If you are a nonprofit organisation working in the Cape Winelands, you are invited to apply for Valcare Membership for the 2020 calendar year.
Being a member of Valcare offers a number of benefits that will strengthen, connect and empower your organisation. To read more about what Valcare membership entails, the costs and the benefits, please click here.

Please select one of the below options to start the Membership Application process
Renewing Valcare membershipBecoming a Valcare member for the first time

Please note that if you are an Early Childhood Development Centre (ECD), you will have to register to become a member of our ECD Partner, Inceba Trust by clicking here. Your Inceba Membership will grant you access to Valcare benefits.

If you have any challenges applying online, please contact reception@valcare.org.za and we'll gladly assist you.

Organisation Details

Name of organisation *

Office number *

General Org E-mail *

Facebook page address

Website

Brief overview of your organisation [100 words] *
List other programmes or projects within your organisation [100 words] *

Current number of paid staff members at your organisation *

Number of volunteers that are involved with your organisation *

Primary contact

First Name *

Last Name *

Job title *

Cellphone no *

E-mail *

Communication / Alternative contact

First Name *

Last Name *

Job title *

Cellphone No *

E-mail *

Physical Address of the organisation’s head office

Building/house number *

Street name *

Suburb *

City *

Postal Address

Same as Physical Address?
YesNo

Building

Street name/ PO Box

Suburb

City

Registration information

Is your organisation registered?
YesNo

Is your organisation registered as an NPO?
YesNo

Registation number
Date of registration

Is your organisation registered as an NPC?
YesNo

Registation number
Date of registration

Is your organisation registered as a Trust?
YesNo

Registation number
Date of registration

Is your organisation registered as a Partial Care Facility?
YesNo

Registation number
Date of registration

Other type of registration
YesNo

Please Specify
Registation number
Date of registration

Focus Areas

Please choose the categories that would best describe your programme or project
Programme/Project 1

A. Primary beneficiary your organisation reaches (Select multiple)

Youth (18 - 35)Vulnerable Children (0-18)Older Persons (65+)Persons with DisabilitiesVulnerable WomenChildren and FamiliesPrisoners and Ex-OffendersHomeless PeopleNon-Profit Organisations

Please Specify Other

B. Primary service your organisation provides (Select multiple)
Skills Development and Job ReadinessTraining and Capacity Building for OrganisationsSport and RecreationEarly Childhood DevelopmentEducation SupportFood and Nutritional SupportSpiritual Care and Social Well-beingHealth CareCommunity Safe SpacesSocial Services and SupportCommunity Engagement and Advocacy

Please Specify Other

Project information

Project location/s *
FranschhoekGouda/Saron/HermonKlapmutsMbekweniSimondiumStellenboschWellingtonPaarlPaarl-EastOther

Specify Other Project location

Number of beneficiaries per age group
Children 0-5
Children 6-12
Children 13-18
Young Adults 19 - 25
Young Adults 26-35
Adults 35-59
Elderly 60+
Total number of beneficaries

Do you hand out food?
YesNo

What time of year?
WinterSummerWhole year
What days?
MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundaysOnly when available
What type of meal?
BreakfastLunchDinnerSnacksOther

Can you confirm that 75% of your beneficiaries are individuals who meet the definition Black as defined in terms of the Department of Trade and Industry's Broad-based Black Economic Empowerment(B-BEE) Codes of Good Practice
YesNo

Resources Available

Please indicate what resources you have to offer or make available to other Valcare Members
Peer trainingVenueFacilitiesPreferred service providers
Please specify

Please note the following documents need to accompany your application form: Registration documents, Constitution
- The following file types are allowed: pdf, jpg, bmp, png, doc, docx, xls, xlsx.
- Maximum size per file: 5MB.

Registration documents *

Constitution documents *

We give permission to Valcare to send us relevant communication via email and SMS. *YesNo

* Required fields.