Phone Bio Ghana Network - Membership Registration Form Personal/Company details (Please fill the forms in English and in BLOCK LETTERS only) Company Name: * Title Mr. Mrs. Ms. Dr. Prof Name of Company Representative: * Address/P.O. Box: * Region/City: Email Address: * Website: Mobile: * Products or Crop(s) exporting/importing /advisory: Fruits/Tree Crops Mango Pineapple Orange Banana Papaya (Pawpaw) Passion Fruit Lemon Coconut Miracle Berries Moringa Plantain Other Vegetables/Root Crops/Cereals Tomato Pepper (Green/Red) Chilly Peppers Mushrooms Onions Garlic Okra Carrot Radish Lettuce Cucumber Garden Eggs Yam Cassava Sweet Potato Potato Asian Vegetables Corn/ pulses/ cereals/ beans/grains Other Livestock Meat Poultry Fish/Seafood Dairy Products Eggs Other Confectionary/Condiments Snacks Sauces Peels Herbs/Spices Baked Goods Spreads (i.e Honey) Oils Chocolate Drinks/Juices Frozen Goods (Ice Scream) Other Non-Food Inputs Seeds and Plants Cosmetics Medicines Other Service Provider Advisory/Support Services Training Specification,Inspection Other Certification Label Organic Global Cap Green Label HACCP UTZ Rainforest Alliance Fairtrade Other Company category (please tick as appropriate): Organic Exporter Organic Importer Organic Advisory Other Commitments: I/We wish to become a member of the Bio Ghana Network and commit to positively promoting Ghana's organic industry. Agree I/We would like to participate in the Annual General Meeting (AGM) of Bio Ghana Network scheduled for Tuesday 31st October 2017 in Accra. Agree I/We would like to have our company contact details displayed on the Bio Ghana Network website and in the 2018-2019 Ghana Organic Directory (distributed nationwide & at Biofach Organic Trade Fair. Agree To benefit from the wide-ranging services of the Bio Ghana Network, I/We agree to pay a yearly membership subscription fee of only five hundred Ghana Cedis (GHC 500). Agree I/We agree that 10% of our membership registration fee will go towards representation by Bio Ghana Network on the Eological Organic Agriculture Platform of Ghana (EOAPG) - the national umbrella organization for organic agriculture in Ghana - allowing for dialogue and linkages with key actors in the organic industry both domestically and internationally such as IFOAM and FIBL. Agree I/We agree that 5% of our membership registration fee will go towards Bio Ghana Network membership fees to the Federation of Ghanaian Exporters (FAGE) who assist their export association members in developing and marketing their products, whilst improving the enabling environment for trade through government advocacy. Agree Initials of Company Representative Date Contact For further information on the Bio Ghana Network, please feel free to contact us by email at info@bioghanan.net or by phone (David Gyasi) at 0501 607 666