Health and Environment Alliance

To apply for membership on behalf of your organisation, please complete the form below and select Submit. Mandatory fields are marked with an asterisk and cannot be left blank.

By submitting a membership application, your organisation commits to sharing the mission of the Health and Environment Alliance and to paying applicable annual membership fees.

Your membership application will be examined by the secretariat and the Executive Committee. If your organisation meets our membership criteria, the Executive Committee will recommend that your membership application be approved by HEAL members at the next General Assembly meeting. We will keep you informed of your application's progress.

If you have any questions, please write to membership@env-health.org.

Organisation's full name
*

Organisation's short name or acronym

Address line 1
*

Address line 2

City
*

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Membership application

Organisation's full name
*

Organisation's short name or acronym

Address line 1
*

Address line 2

City
*

Postal code
*

Country
*

Organisation's website
*

General phone number

General email address
*

Main contact's first name
*

Main contact's surname
*

Main contact's job title or function
*

Main contact's email address
*

Who should receive annual membership fee bills?
*

Finance contact's first name (if applicable)

Finance contact's surname (if applicable)

Finance contact's email address

When was your organisation established?

Please select the type(s) of organisation that best describe your organisation.
*

Does your organisation have its own network of members (organisations or individiduals)? If so, please specify how many members you have.

How is your organisation funded?
*

What is your organisation's annual budget in euros?
*

What are your organisation's main objectives and activities?
*

Which membership category would you like to apply for?
*

Please upload your organisation's statutes or bylaws.
*

Please upload a copy of your organisation's most recent annual accounts.
*

Communications contact first name (if applicable)

Communications contact's surname (if applicable)

Communications contact's email address (if applicable)

Does your organisation have major publications? If so, please specify details below.

Does your organisation have a Facebook account? If so, please enter details below.

Does your organisation have an X account? If so, please enter details below.

Does your organisation have a BlueSky account? If so, please enter details below.

Does your organisation have a LinkedIn account? If so, please enter details below.

Does your organisation have a YouTube channel? If so, please enter details below.

Does your organisation use other social media channels? If so, please specify details below, including URLs to your organisation's account(s).

Does your organisation publish a newsletter? If so, please enter details below.

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Organisation's full name *

Organisation's short name or acronym

Address line 1 *

Address line 2

City *

Postal code *

Country *

Organisation's website *

General phone number

General email address *

Main contact's first name *

Main contact's surname *

Main contact's job title or function *

Main contact's email address *

Who should receive annual membership fee bills? *

Finance contact's first name (if applicable)

Finance contact's surname (if applicable)

Finance contact's email address

When was your organisation established?

Please select the type(s) of organisation that best describe your organisation. *

Does your organisation have its own network of members (organisations or individiduals)? If so, please specify how many members you have.

How is your organisation funded? *

What is your organisation's annual budget in euros? *

What are your organisation's main objectives and activities? *

Which membership category would you like to apply for? *

Please upload your organisation's statutes or bylaws. *

Please upload a copy of your organisation's most recent annual accounts. *

Communications contact first name (if applicable)

Communications contact's surname (if applicable)

Communications contact's email address (if applicable)

Does your organisation have major publications? If so, please specify details below.

Does your organisation have a Facebook account? If so, please enter details below.

Does your organisation have an X account? If so, please enter details below.

Does your organisation have a BlueSky account? If so, please enter details below.

Does your organisation have a LinkedIn account? If so, please enter details below.

Does your organisation have a YouTube channel? If so, please enter details below.

Does your organisation use other social media channels? If so, please specify details below, including URLs to your organisation's account(s).

Does your organisation publish a newsletter? If so, please enter details below.

Organisation's full name
*

Address line 1
*

City
*

Postal code
*

Country
*

Organisation's website
*

General email address
*

Main contact's first name
*

Main contact's surname
*

Main contact's job title or function
*

Main contact's email address
*

Who should receive annual membership fee bills?
*

Please select the type(s) of organisation that best describe your organisation.
*

How is your organisation funded?
*

What is your organisation's annual budget in euros?
*

What are your organisation's main objectives and activities?
*

Which membership category would you like to apply for?
*

Please upload your organisation's statutes or bylaws.
*

Please upload a copy of your organisation's most recent annual accounts.
*