Name of Organization*
Acronym*
User Name*
Mailing Address*
Physical Address if Different*
Phone Number*
Fax Number*
Website URL*
Fiscal Year*
Size of Annual Budget*
CEO/Executive Director*
E-Mail*
Secondary Contact*
E-Mail*
Geographic Scope of Association*
	National/Jordan
	Arab/Regional
	Global/Int’l.
Year the Organization Was Founded*
Why are you completing the Association Self-Assessment Process?*
What outcomes and benefits do you anticipate from the Self-Assessment process?*
Who from your staff and board will participate in the Self-Assessment process?*