Application Details

Contact Details

Request Received
Network Membership
This is a Lifetime membership
This membership includes Unlimited member slot(s)

Network Members are patient organizations or healthcare-related organizations, networks or alliances committed to improving healthcare and to the principle of patient-centred healthcare. 

Network Members enjoy free membership at IAPO while having restricted rights and benefits:

  • No voting rights in the Annual General Assembly or Extraordinary Meetings;
  • Participation as an observer in the Annual General Assembly and Extraordinary Meetings;
  • No rights to nominate candidates for the Governing Board; 
  • No rights to represent IAPO at the WHO Regional Committee meetings, and international or regional events;
  • No rights to use our Members logo on their communication channels and other promotional materials.

Network Members must meet all the criteria below:

  1. Must be non-profit and non-governmental.
  2. Must have a legal status appropriate to the country of origin.
  3. May be an international, regional, national or local organization, or an umbrella group.
  4. The organization must demonstrate commitment to improving healthcare and to the principle of patient-centred healthcare.

Glue Up account creation information.

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Please enter a first name
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Please enter a last name
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・8 characters minimum
・one upper case letter
・one lower case letter
・one number
・one special character (@$!%*?&)
If you input more than 0 characters your Password may not display properly


・8 characters minimum
・one upper case letter
・one lower case letter
・one number
・one special character (@$!%*?&)
If you input more than 0 characters your Confirm password (at least 8 characters) may not display properly

Please fill in your individual information.

Please fill in the below form with your company details.

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PART A. DETAILS OF YOUR ORGANIZATION
Please enter a company name

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Please enter a year established
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If you input more than 0 characters your Organization Name (in english if different to legally registered name) may not display properly

Please enter a disease area ( e.g ovarian cancer, diabetes, cross-disease)
If you input more than 0 characters your Disease area ( e.g Ovarian Cancer, Diabetes, Cross-Disease) may not display properly
Please select an option

Please enter a organizational annual income in usd
If you input more than 0 characters your Organizational annual income in USD may not display properly

Please enter a organization profile (please let us know, in a maximum of 100 words, about the work of your organization)
If you input more than 0 characters your Organization profile (Please let us know, in a maximum of 100 words, about the work of your organization) may not display properly
Please select an option

If you input more than 0 characters your Approximately how many individuals does your organization represent? e.g patients, family, caregivers,supporters etc (if applicable) may not display properly

If you input more than 0 characters your Approximately how many patients does your organization represent overrall? may not display properly

Please enter a building number or name and street name
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Please enter a city, province or state
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Please enter a post or zip code
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Please enter a telephone number (with country code)
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If you input more than 0 characters your Website may not display properly

If you input more than 0 characters your Youtube may not display properly

If you input more than 0 characters your Twitter may not display properly

If you input more than 0 characters your Linkedin may not display properly

If you input more than 0 characters your Facebook may not display properly
PART B. DETAILS OF YOUR IAPO REPRESENTATIVES

The IAPO Representatives should be the people we can liaise with when communicating with your organization. Whilst you may put your Chief Executive as the IAPO Representative, please consider carefully if he or she will have sufficient time to respond to our communications. You may alternatively wish to put down the name of a member of the governing body, or a senior manager involved in external affairs, policy, collaboration or another appropriate area.

 

In giving us their details, these people agree to:

 

• Receive annual renewal invoices.

• Respond to consultations where relevant for your organization.

• Represent your organization at IAPO's General Assembly.

• Receive communications from IAPO.

IAPO REPRESENTATIVE 1

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Please enter a last name
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Please enter a position
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Please enter a email address
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Please enter a valid phone number including country code
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IAPO REPRESENTATIVE 2

Please enter a first name
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If you input more than 0 characters your Last Name may not display properly

If you input more than 0 characters your Position may not display properly

If you input more than 0 characters your Email address may not display properly

If you input more than 0 characters your Direct telephone (with country code) may not display properly

If anyone in your organization would like to receive newsletters, please give their details below.

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If you input more than 0 characters your Last Name may not display properly

If you input more than 0 characters your Position may not display properly

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PART C. MEMBERSHIP CATEGORY AND SUPPORTING DOCUMENTS
Please select an option

Please note that you must provide supporting documentation specified below to be considered for membership.

Click here to upload a file
Please upload a valid upload your legal registration document - originals and english translation (if applicable). if no appropriate legal status exists this criteria may be waived at the discretion of iapo’s governing board.
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Please upload a valid upload written evidence of commitment to patients and the principle of patient centred healthcare, for example a statement, letter, strategic plan, mission and vision, or by-laws and constitution - originals and english translation (if applicable).
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Please select an option
PART D. DECLARATION

By submitting this application you are agreeing to your organization's details being kept on IAPO's database. We will not share any information about your organization (apart from the publicly-available information on our website) with anyone else without your permission. 

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Consent

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