境外非政府组织代表机构登记事项表Registration Details of Representative Offices of Overseas Nongovernmental Organizations 境外非政府组织
外文名称及简称
(Name and Abbreviation
of the Overseas NGO）
中文名称
(Name in Chinese)
注册国家
(Country of Registration)注册时间
(Date of Registration )
总部地址
(Address of
Head Office)
负责人姓名
(Name of the person in charge)
业务范围及
活动宗旨
(Scope and purpose of operations)
拟设代表机构名称
(Name of the proposed Representative Office)
拟任首席代表姓名
(Name of Appointee for Chief Representative of Representative Office)
联系人(Contact person) 联系电话(Contact phone number)
电子邮箱
(E-mail)
资金来源（Source of supporting funds）
业务范围（Scope of operations）
活动地域（Areas of Activity）
住所地址（Registered Address）
活动领域(Fields of Activity)：
□经济(Economy)□教育(Education)□科技（Science & Technology）□文化（Culture）□卫生（Health）□体育（Sports）□环保(Environment Protection)□济困救灾(Poverty a nd Disaster relief) □其它(Other)
代表机构拟任首席代表
签名(Signature of Chief
Representative of the Representative
Office to be Appointed)
日期：年月日
Date ________ (dd / mm / yy)
业务主管单位意见
（Approval or disapproval of
Organizations in charge of operations ）
（盖章）Seal 日期：年月日Date ________ (dd / mm / yy)
、