Membership Application Form

Name Of Organization/Company/Group/Individual: Name of Contact Person Representing the Organization or Group:

Physical and Postal Address: Telephone Number:

Fax Number: E-Mail:

Website:

Indicate the organic sector your organization is involved in (please tick): ProducerProcessorTraderExporterConsumerTrainerResearcherOthers Provide Location for each selected sector: Declaration:

Full Name: Signature:

Date: Official Stamp (if applicable):

Please indicate the category of your membership: How did you know about TOAM?

Payment can be made through a bank transfer to CRDB bank ltd at Tower Branch in Dar es Salaam to account number 01J1043011900. Please scan the pay-in slip and send it to the email address above.

A duly filled application should be returned to the TOAM office through the address given above. Thank you.

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