Olive Nest Partner Vetting & Registration

SECTION 1 — ORGANIZATION BASIC INFORMATION

Provide accurate organisational details for due diligence.

1. Name of Rehabilitation Home *

2. Year Organization Was Established *

3. CAC Registration Number *

4. Type of Organization *

If “Other”, please specify

5. Physical Address of Facility *

6. State and Local Government Area *

7. Organisation Phone Number *

8. Official Email Address *

9. Website / Social Media Links (optional)

SECTION 2 — CONTACT PERSON DETAILS

Primary contact for partnership communication.

10. Full Name of Primary Contact Person *

11. Position / Role in Organization *

12. Phone Number (WhatsApp if available) *

13. Email Address *

SECTION 3 — GOVERNANCE & LEADERSHIP STRUCTURE

Governance, staffing, and safeguarding readiness.

14. Does your organization have a Board of Trustees or Management Committee? *

15. Please list names and roles of Board Members / Management Team *

16. Total Number of Staff Working in Your Organization *

17. Number of Clinical / Counseling Staff/Volunteers *

18. Key staff qualifications related to rehabilitation / substance misuse / mental health services *

19. Does your organization have any of the following policies? *

Safeguarding Policy

Child Protection Policy

Client Confidentiality Policy

Staff Code of Conduct

None

Other (Specify)

If “None” is selected, leave other policy checkboxes unchecked.

SECTION 4 — SERVICE DELIVERY INFORMATION

Service model, capacity, and client workflow.

20. What type of rehabilitation services do you provide? *

Drug / Substance Misuse Rehabilitation

Alcohol Rehabilitation

Mental Health Rehabilitation

Youth Rehabilitation

Faith-Based Recovery Program

Other (Specify)

21. What treatment methods or models do you use? *

22. How many residents/clients can your facility accommodate at a time? *

23. Approximately how many clients do you serve per year? *

24. Do you provide inpatient, outpatient, or both services? *

25. Briefly describe your referral and admission process *

SECTION 5 — FINANCIAL ACCOUNTABILITY

Banking and controls for accountability.

26. Name of Organization Bank Account *

27. Bank Name *

28. Does your organization maintain financial records and expenditure tracking? *

29. Who approves spending decisions in your organization? *

30. Has your organization received donor or grant funding before? *

31. If yes, please briefly describe previous funding support

SECTION 6 — URGENT FUNDING NEEDS ASSESSMENT

Project details used for fundraising planning.

32. Project or Need Title *

Example: “Feeding Support for Residents” or “Therapy Sponsorship Program”

33. Please describe the urgent need or project *

34. Why is this need urgent? *

35. Number of beneficiaries that will be supported *

36. Please provide an itemised budget breakdown *

37. Estimated Total Funding Required (₦) *

38. When is the funding needed? *

39. Expected outcomes or impact if funding is received *

SECTION 7 — MONITORING & REPORTING CAPACITY

Ability to provide evidence and accountability artifacts.

40. Is your organization able to provide progress and financial reports after receiving funding? *

41. Are you able to provide photos, testimonials, or project updates (with client consent)? *

SECTION 8 — DOCUMENT UPLOAD

Required Uploads: CAC Registration Certificate, Governing Document/Constitution, Organizational Structure or Board List, Most Recent Financial Report or Income/Expenditure Summary, Relevant Operational License (if applicable).

Drag & drop files here

or click to browse (max 10 files total)

Selected files (from Drag/Drop)

Add file lines

Use this if you prefer uploading one-by-one per row.

Total files across both methods cannot exceed 10.

SECTION 9 — TRAINING & CAPACITY DEVELOPMENT NEEDS

Optional training needs to inform capacity building support.

43. Are you interested in staff training and capacity development support from Olive Nest?

44. What training areas would benefit your staff?

Substance Misuse Treatment

Trauma-Informed Care

Mental Health & Dual Diagnosis

Safeguarding & Client Protection

Program Management

Other (Specify)

SECTION 10 — DECLARATION & CONSENT

Confirmation of accuracy and consent for verification.

45. Declaration Statement *

I confirm that the information provided is accurate and truthful. I understand Olive Nest may verify the information provided and request additional documentation before partnership approval.

46. Name of Person Completing Form *

47. Position *

48. Date *

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Address

Olive Nest Partner Vetting & Registration Form

SECTION 1 — ORGANIZATION BASIC INFORMATION

SECTION 2 — CONTACT PERSON DETAILS

SECTION 3 — GOVERNANCE & LEADERSHIP STRUCTURE

SECTION 4 — SERVICE DELIVERY INFORMATION

SECTION 5 — FINANCIAL ACCOUNTABILITY

SECTION 6 — URGENT FUNDING NEEDS ASSESSMENT

SECTION 7 — MONITORING & REPORTING CAPACITY

SECTION 8 — DOCUMENT UPLOAD

SECTION 9 — TRAINING & CAPACITY DEVELOPMENT NEEDS

SECTION 10 — DECLARATION & CONSENT