Registration for Membership Form

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  • Full Name of the organization*in English or Persian
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  • • Country of Headquarters*
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  • • Official Organizational Email for Correspondence*
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  • • Official Website Address*
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  • • Direct Telephone Number or Secretariat Contact Line*کامل
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  • • Areas of Expertise and Activities*Please tick all applicable fields:
    • Public Health
    • Primary Health Care (PHC)
    • Mental Health and Psychosocial Support
    • Emergency Response and Relief Operations
    • Peacebuilding and Conflict Resolution
    • Crisis-related Research and Data Collection
    • Education and Capacity-Building
    • Military Medicine / Medicine in Conflict Settings
    • Information, Public Outreach, and Media
    • Other (please specify)
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  • Capacities and Resources
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  • • Number of active experts and/or volunteers*
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  • • Key specializations (e.g., medical—please specify field, education, research, etc.)*
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  • • Major equipment or infrastructure (e.g., mobile clinics, rapid response teams, training centers, data repositories)*
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  • • Source(s) of financial support*
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  • • Experience and Projects
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  • • Brief list of major projects in the past two years (include title and year of implementation)*
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  • • Link to project reports or official webpages*توضیح بیشتر
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  • • Section to upload the organization’s portfolio or résumé*upload your file upload
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    • Interest in Collaboration with the Network
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    • Please indicate which working groups your organization is willing to join:*
      • Participation in events and campaigns
      • Provision of financial, physical, and informational resources
      • Collaborative research and training (please specify selected domain(s)):
      • Please specify any additional skills, resources, or perspectives your organization can contribute.
      • In one sentence, please indicate what motivates you to join the Global Network for Health and Peace.
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    • • Collaborative research and training (please specify selected domain(s)):*
      Evidence generation through research and analysis
      Development of strategic and operational frameworks
      Advocacy and awareness-raising (campaigns, professional and public training, etc.)
      Capacity-building
      o Capacity-building
      o Mainstreaming the Health and Peace Approach
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    • Official Representative to the Network
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    • • Full Name of the Official Representative*
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    • • Organizational Position*
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    • • Personal or Institutional Email Address*
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    • • Mobile Phone Number (optional)*
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    • A brief statement clarifying that all provided information will be used solely for network-related activities and stored in full compliance with privacy protection regulations. Confirmation will be requested via email to validate the address provided.
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    • • Final confirmation checkbox*
      • Final confirmation checkbox
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