Full and Associate Membership Application Our NetworkApply to be a Member Full and Associate Membership Application In this section Full and Associate Membership Application FULL AND ASSOCIATE MEMBERSHIP APPLICATION FORM ASSOCIATION DETAILS Association Name Address Postcode Country Association Website Telephone Email Provide brief summary on Mission, Aims or Goals of Association Membership Eligibility Please select... Researcher Bariatric surgeon Cardiologist Consultant Dietitian Diabetes educators Diabetologist Bariatric physician Endocrinologist Media Advocate Medical officer Nurse Nutritionist Paediatric endocrinologist Patient Physiotherapist Paediatrician Physician Psychologist Population Health Expert Public Health Advisor Other Please select one or more options to be eligible to join your association APPLICATION INFORMATION Number of your current members EXECUTIVE BOARD INFORMATION First Name Last Name Email Role on the Executive Board Please select... President Vice-President Treasurer Secretary Board Member Other Position Please select... Researcher Bariatric surgeon Cardiologist Consultant Dietitian Diabetes educators Diabetologist Bariatric physician Endocrinologist Media Advocate Medical officer Nurse Nutritionist Paediatric endocrinologist Physiotherapist Paediatrician Physician Psychologist Population Health Expert Public Health Advisor Other Specify Other (Role) Is this also the Administrative point of contact? Yes No If no please complete the following additional Administrator Point of Contact information section below ADDITIONAL ADMINISTRATIVE POINT OF CONTACT First Name Last Name Email Position Please select... Researcher Bariatric surgeon Cardiologist Consultant Dietitian Diabetes educators Diabetologist Bariatric physician Endocrinologist Media Advocate Medical officer Nurse Nutritionist Paediatric endocrinologist Physiotherapist Paediatrician Physician Psychologist Population Health Expert Public Health Advisor Other POC ADMINISTRATOR INFORMATION First Name Last Name Email Position Please select... Researcher Bariatric surgeon Cardiologist Consultant Dietitian Diabetes educators Diabetologist Bariatric physician Endocrinologist Media Advocate Medical officer Nurse Nutritionist Paediatric endocrinologist Physiotherapist Paediatrician Physician Psychologist Population Health Expert Public Health Advisor Other DECLARATION I declare that: The Association is not-for-profit The Association has similar objectives to that of WORLD OBESITY The Association has a minimum of 15 members I declare that the information I have provided in the application is truthful. Once the Association becomes a member, it agrees to pay the annual membership fee requested by WORLD OBESITY Applicant Name Role of signatory Applicant Signature Date REQUIRED DOCUMENTATION Please ensure that the following documentation is included with the completed application form: Official request to apply for WORLD OBESITY National or Associate membership on behalf of the Executive Committee of the applying Association Letter from the president Association's current constitution Constitution document Sample of any professional publications Alternatively you can send the application and supporting documents to: WORLD OBESITY FEDERATION Ludgate House Suite 406 107-111 Fleet Street London EC4A 2AB United Kingdom Or via Email to Membership@worldobesity.org Once the application form and associated documents have been received, The Membership Committee, will review the application, it will be then be referred to the Executive Committee with a recommendation to accept or reasons to reject the application. If further information is required you will be contacted. All membership applications are reviewed by the Membership Committee and formally approved by the Board of Trustees on a quarterly basis. For further details and any enquiries please contact Membership@worldobesity.org. Please note that WORLD OBESITY will not be able to process incomplete applications or those missing required documents. Contact Information We do not store credit card details nor do we share financial details with any 3rd parties. Share this page