REF AA1 Appl Assist

St Lucia Business Executive Services Trust (BEST) Voluntary Assistance Programme Assistance Application Form

Ref AA1

A. General Information Organization____________________________________________________________________ Address________________________________________________________________________ Email Address___________________________________________________________________ Contact Person __________________________________________________________________ Phone___________________________________

Fax_________________________________

Note: The contact person must be an authorized staff person requesting assistance.

B. Project Description / Assistance Required___________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

C. Expertise / Skills Required________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

St Lucia Business Executive Services Trust (BEST) Voluntary Assistance Programme Assistance Application Form Ref AA1 D. Duration of the Assignment_______________________________________________________ Proposed Timing _______________________________________________________________ _______________________________________________________________________________ Counterpart Assigned?

Yes

No

E. Attachments Please enclose the following items (as applicable) with this application form and check the appropriate boxes.

Brief description of the Organization and its activities List of activities to be undertaken by the consultant F. Statement of Assurances The applicant certifies to the Office of Private Sector Relations that: i.

The information contained in the application and in any attachments is true and correct

ii.

The applicant has read and is in agreement with the Terms and Conditions of St Lucia Business Executive Services Trust (BEST)

iii.

The applicant is willing and able to meet their contribution to financing and facilitating the assignment

________________________ Signature

____________________________________ Printed Name

______________ Date