115 APPLICATION FORM FOR THE PUBLIC CALL FOR SELECTION OF THE ASSOCIATION REPUBLIC OF SERBIA PROTECTOR OF CITIZENS Belgrade APPLICATION on the basis of PUBLIC CALL for Cooperation in Performing Tasks of the NATIONAL PREVENTIVE MECHANISM AGAINST TORTURE Full Association Name Abbreviated Association Name Association Address Association E-mail Association Web Address Telephone Association Reg. No. Registration Authority Association founding date Statutory objectives of the Association Person authorized for representation (Name, Position, ID No.) Exhibits 1. Decision on the Association Registration; 2. Association Statute; 3. Description of Association’s activities; 4. List of reports and publications of the Association; 5. Qualification structure Place and Date Signature and Seal