Application for Registration of Citizen Community Board
The Executive District Officer
We the undersigned propose to establish a Citizen Community Board (CCB) in accordance with the provisions of Local Government Ordinance 2001.
2. The particulars of the proposed Citizen Community Board are given below:
a) Title / name of the CCB
b) Address and Telephone No.
c) Field of Operation
§ Management of service delivery facilities .
§ Up gradation of existing outlet
§ Establishment of new outlet
§ Capacity building
§ Others specify
h) Sectors and Sub-sector of interest.
Agriculture / Health / Education / Others specify
3. Provide the Designations, Names, Education, occupation and addresses of the office bearers.
4. It is requested that our CCB may please be registered under the aforesaid Ordinance. We undertake to inform you of any changes in the composition of the office bearers of the CCB within 15 days.
5. We certify that the information given above is correct.
Signature of Witnesses
With name and address