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Application form
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Thank you for submitting your full member application form. We will return to you when the Board has reviewed the application.
Your first name
Your last name
Your personal e-mail address
In case we have further questions
About your organisation
Your Organisations Name
Postal adrress
Address
City
State/Province
ZIP code
Allowed characters are: 0-9
Country
Your organisations telephone number
Remember country code
Allowed characters are: 0-9
Office mail of your organisation
Website address
Key Contact
Name of person, and his/her role in the organisation
Year of legal registration
Brief description of your organisation
Mission, key objectives and key initiatives of your organisation
Key motivation to join the federation (your statement on why you want to be part of EU-IPFF)
Number of members or patients your organisation represents today
Allowed characters are: 0-9
As representative of my organisation, I expressly agree to and accept the EU-IPFF Statutes and the Code of Conduct
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Yes
No
As representative of my organisation, I declare that:
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My organisation has no profit-making purposes
My organisation is independent from commercial and political interest
An important part of our activities develops implements and influences policies for the promotion of IPF care and services
My organisation commits to pay annual fees on demand
My organisation commits to share the aims and objectives of EU-IPFF
Neither the organisation nor its members have a potential conflict of interest
Please upload the statutes of your organisation (in their official language) if available ADD YOUR FILES
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Max filesize: 10MB
Please upload your latest annual report & accounts - if available
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Privacy Policy(*) *
I read the privacy policy and agree
Note: All the data submitted in this formular will be deleted 19-07-2021
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