Business Registration Form
United in Crisis - South Africa (UIC-SA) is looking for businesses, organizations, and groups within the community that can partner with us to provide available resources, financial support, and collaborate efforts in and out of crisis response. There are several ways to engage with us. To get started, please complete the following Business Registration form below. Someone from our Partner Ministries department will be in touch with you soon. Thank you for your support and interest in UIC-SA!
Name of Organization
*
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Information
Contact Person
*
First Name
Last Name
Title
Cell Phone Number
*
-
Country Code
-
Area Code
Phone Number
E-mail
*
example@example.com
CEO of Organization
*
First Name
Last Name
Business Information
Number of Employees
*
Please Select
Under 50
50-250
250-750
750-2,000
over 2,000
Which of the following areas can the organization provide the network in a time of crisis?
*
Volunteer Support
Warehouse Space
Disaster Supplies (i.e. supplies for hygiene kits, care kits, clean-up kits, and more)
Disaster Funds (i.e. emergency housing, transportation, building materials, etc..)
Printing of Training Materials
Other
If you checked "Warehouse Space" above, how much space can you approximately designate for storage within your facility or a facility you own in times of crisis (i.e. food, water, disaster supplies)?
92,903 sq. mt. or less
92,903-464,515 sq. mt.
464,515-929,03 sq. mt.
Over 929,03 sq. mt.
None
If you checked "Other" above, please let us know how you can partner with us?
Enter the message as it's shown
*
Submit
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