Membership Application Form | World Obesity Federation

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class="nav-link" href="https://www.worldobesity.org/news">News</a> </li> <li class="nav-item"> <a class="nav-link site-search" href="#" data-toggle="modal" data-target=".modal-site-search"><i class="icon-wof_search"></i></a> </li> </ul> </div> </div> </div> </nav> </header> <main> <article> <header> <div class="container"> <div class="row"> <div class="col-12 col-lg-10"> <h1>Membership Application Form</h1> </div> </div> </div> </header> <div class="page-meta card mb-5"> <div class="page-meta-bar"> <div class="container"> <div class="row"> <div class="col-12"> <p><small class="upper"><a href="https://www.worldobesity.org/our-network/">Our Network</a><a href="https://www.worldobesity.org/our-network/apply-to-be-a-member/">Apply to be a Member </a><span class="last">Membership Application Form</span></small></p> <a class="btn btn-primary float-right" data-toggle="collapse" href="#section-nav" role="button" aria-expanded="false" aria-controls="section-nav"> <i class="icon-wof_menu"></i> In this section </a> </div> </div> </div> </div> <div class="page-meta-nav"> <div class="collapse" id="section-nav"> <div class="container"> <div class="row"> <div class="col-12"> <ul> <li class="active"> <a href="/our-network/apply-to-be-a-member/membership-application-form/">Membership Application Form</a> </li> </ul> </div> </div> </div> </div> </div> </div> <div class="social-share-top d-none d-md-block"> <div class="container"> <div class="row"> <div class="col-12"> <ul class="share-icons"> <li data-aos="fade" data-aos-offset="100" data-aos-delay="100"><a class="facebook" href="https://www.facebook.com/sharer/sharer.php?u=https://www.worldobesity.org/our-network/apply-to-be-a-member/membership-application-form" target="_blank"><i class="fab fa-facebook-f"></i></a></li> <li data-aos="fade" data-aos-offset="100" data-aos-delay="200"><a class="twitter" href="https://twitter.com/home?status=https://www.worldobesity.org/our-network/apply-to-be-a-member/membership-application-form" 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document.getElementById('submit_button'); var explanation = document.getElementById('disabled-explanation'); if (submitButton != null) { submitButton.disabled = true; if (explanation != null) { explanation.style.display = 'block'; } } }; // call this on both captcha async complete and wforms fully // initialized since we can't be sure which will complete first // and we need both done for this to function just check that they are // done to fire the functionality var onloadCallback = function () { // if our captcha is ready (async call completed) // and wFORMS is completely loaded then we are ready to add // the captcha to the page if (captchaReady && wFORMSReady) { grecaptcha.enterprise.render('g-recaptcha-render-div', { 'sitekey': '6LfMg_EaAAAAAMhDNLMlgqDChzmtYHlx1yU2y7GI', 'theme': 'light', 'size': 'normal', 'callback': 'enableSubmitButton', 'expired-callback': 'disableSubmitButton' }) var oldRecaptchaCheck = parseInt('1'); if (oldRecaptchaCheck === -1) { var standardCaptcha = 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role="form" enctype="multipart/form-data"> <div class="htmlSection" id="tfa_90"><div class="htmlContent" id="tfa_90-HTML"><div style="text-align: right;"><span style="font-size: 13.6px; word-spacing: normal;"><img src="//www.tfaforms.com/forms/get_image/210014/Y4h2itfvPxZeMYFdzSaTNrqiWQUF53fl8y0cS8dEUA6fRUcad86k3ck4FkzM1ciJ-download.png" alt="WORLD OBESITY FEDERATION" style="max-width: 100%;float:left;"> </span></div></div></div> <fieldset id="tfa_1" class="section"> <legend id="tfa_1-L"><b>ASSOCIATION DETAILS</b></legend> <div class="oneField field-container-D " id="tfa_2-D"> <label id="tfa_2-L" class="label preField reqMark" for="tfa_2">Association Name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2" name="tfa_2" value="" title="Association Name" class="required"></div> </div> <div id="tfa_102" class="section inline group"> <div class="oneField field-container-D " id="tfa_3-D"> <label id="tfa_3-L" class="label preField reqMark" for="tfa_3">Address</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_3" name="tfa_3" value="" title="Address" class="required"></div> </div> <div class="oneField field-container-D " id="tfa_4-D"> <label id="tfa_4-L" class="label preField reqMark" for="tfa_4">Postcode</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_4" name="tfa_4" value="" title="Postcode" class="required"></div> </div> </div> <div id="tfa_103" class="section inline group"> <div class="oneField field-container-D " id="tfa_5-D"> <label id="tfa_5-L" class="label preField reqMark" for="tfa_5">Country</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_5" name="tfa_5" value="" title="Country" class="required"></div> </div> <div class="oneField field-container-D " id="tfa_9-D"> <label id="tfa_9-L" class="label preField " for="tfa_9">Association Website</label><br><div class="inputWrapper"><input type="text" id="tfa_9" name="tfa_9" value="" title="Association Website" class=""></div> </div> <div class="oneField field-container-D " id="tfa_6-D"> <label id="tfa_6-L" class="label preField reqMark" for="tfa_6">Telephone</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_6" name="tfa_6" value="" title="Telephone" class="validate-integer required"></div> </div> <div class="oneField field-container-D " id="tfa_7-D"> <label id="tfa_7-L" class="label preField reqMark" for="tfa_7">Email</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_7" name="tfa_7" value="" title="Email" class="validate-email required"></div> </div> </div> <div id="tfa_123" class="section inline group"> <div class="oneField field-container-D " id="tfa_10-D"> <label id="tfa_10-L" class="label preField reqMark" for="tfa_10">Provide brief summary on Mission, Aims or Goals of Association</label><br><div class="inputWrapper"><textarea aria-required="true" maxlength="30000" id="tfa_10" name="tfa_10" title="Provide brief summary on Mission, Aims or Goals of Association" class="required"></textarea></div> </div> <div class="oneField field-container-D hintsSide " id="tfa_119-D"> <label id="tfa_119-L" class="label preField " for="tfa_119">Membership Eligibility </label><br><div class="inputWrapper"> <select id="tfa_119" multiple name="tfa_119[]" title="Membership Eligibility " aria-describedby="tfa_119-HH" class=""><option value="">Please select...</option> <option value="tfa_124" id="tfa_124" class="">Researcher</option> <option value="tfa_125" id="tfa_125" class="">Bariatric surgeon</option> <option value="tfa_126" id="tfa_126" class="">Cardiologist</option> <option value="tfa_127" id="tfa_127" class="">Consultant Dietitian</option> <option value="tfa_128" id="tfa_128" class="">Diabetes educators</option> <option value="tfa_129" id="tfa_129" class="">Diabetologist</option> <option value="tfa_130" id="tfa_130" class="">Bariatric physician</option> <option value="tfa_131" id="tfa_131" class="">Endocrinologist</option> <option value="tfa_132" id="tfa_132" class="">Media Advocate</option> <option value="tfa_133" id="tfa_133" class="">Medical officer</option> <option value="tfa_134" id="tfa_134" class="">Nurse</option> <option value="tfa_135" id="tfa_135" class="">Nutritionist</option> <option value="tfa_136" id="tfa_136" class="">Paediatric endocrinologist</option> <option value="tfa_208" id="tfa_208" class="">Patient</option> <option value="tfa_137" id="tfa_137" class="">Physiotherapist</option> <option value="tfa_138" id="tfa_138" class="">Paediatrician</option> <option value="tfa_139" id="tfa_139" class="">Physician</option> <option value="tfa_140" id="tfa_140" class="">Psychologist</option> <option value="tfa_141" id="tfa_141" class="">Population Health Expert</option> <option value="tfa_142" id="tfa_142" class="">Public Health Advisor</option> <option value="tfa_143" id="tfa_143" class="">Other</option></select><span class="field-hint-inactive" id="tfa_119-H"><span id="tfa_119-HH" class="hint">Please select one or more options to be eligible to join your association </span></span> </div> </div> </div> </fieldset> <fieldset id="tfa_12" class="section"> <legend id="tfa_12-L"><b>APPLICATION INFORMATION</b></legend> <div class="oneField field-container-D " id="tfa_238-D"> <label id="tfa_238-L" class="label preField reqMark" for="tfa_238">Which grade of membership would you like to be considered for?</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_238" name="tfa_238" title="Which grade of membership would you like to be considered for?" class="required"><option value="">Please select...</option> <option value="tfa_239" id="tfa_239" class="">Full Member</option> <option value="tfa_240" id="tfa_240" class="">Associate Member</option> <option value="tfa_241" id="tfa_241" class="">Not sure</option></select></div> </div> <div class="oneField field-container-D " id="tfa_13-D"> <label id="tfa_13-L" class="label preField reqMark" for="tfa_13">Number of your current members</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_13" name="tfa_13" value="" maxlength="20" title="Number of your current members" class="validate-integer required"></div> </div> <div class="htmlSection" id="tfa_14"><div class="htmlContent" id="tfa_14-HTML"><p style="margin-bottom: 0cm; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;" class="MsoNormal"><u><span style="font-size: 10pt;">PLEASE NOTE - MEMBERSHIP FEES ARE BASED ON GROSS ANNUAL INCOME</span></u><span style="font-size: 10pt;"></span></p><p style="margin-bottom: 0cm; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;" class="MsoNormal"><span style="font-size: 10pt;"> </span></p><table style="width: 339.7pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;" width="453" cellpadding="0" cellspacing="0" border="0" class="MsoNormalTable"> <tbody><tr> <td style="width: 107.85pt; border-width: 1pt; border-style: solid; border-color: windowtext; padding: 0cm 5.4pt;" valign="top" width="144"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;"> </span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 231.85pt; border-top: 1pt solid windowtext; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" colspan="2" width="309"> <p style="margin-bottom:0cm;text-align:center; line-height:normal" align="center" class="MsoNormal"><b><span style="font-size: 10pt; color: black;">WOF Membership Fees</span></b><span style="font-size: 12pt;"></span></p> </td> </tr> <tr> <td style="width: 107.85pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="144"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><b><span style="font-size: 10pt; color: black;">Annual Income</span></b><span style="font-size: 12pt;"></span></p> </td> <td style="width: 97.2pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="130"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><b><span style="font-size: 10pt; color: black;">Full Membership</span></b><span style="font-size: 10pt; color: black;"> </span><span style="font-size: 12pt;"></span></p> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">(full benefit package + voting)</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 134.65pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="180"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><b><span style="font-size: 10pt; color: black;">Associate Membership</span></b><span style="font-size: 10pt; color: black;"> </span><span style="font-size: 12pt;"></span></p> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">(limited benefit package/non-voting)</span><span style="font-size: 12pt;"></span></p> </td> </tr> <tr> <td style="width: 107.85pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="144"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢4 million +</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 97.2pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="130"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢10000</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 134.65pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="180"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢5000</span><span style="font-size: 12pt;"></span></p> </td> </tr> <tr> <td style="width: 107.85pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="144"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢1-4 million</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 97.2pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="130"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢5000</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 134.65pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="180"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢2500</span><span style="font-size: 12pt;"></span></p> </td> </tr> <tr> <td style="width: 107.85pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="144"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢100,000 - 拢1 million</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 97.2pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="130"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢1000</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 134.65pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="180"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢500</span><span style="font-size: 12pt;"></span></p> </td> </tr> <tr> <td style="width: 107.85pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="144"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢10,000 - 拢100,000</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 97.2pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="130"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢300</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 134.65pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="180"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢150</span><span style="font-size: 12pt;"></span></p> </td> </tr> <tr> <td style="width: 107.85pt; border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="144"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">Up to 拢10,000</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 97.2pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="130"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢100</span><span style="font-size: 12pt;"></span></p> </td> <td style="width: 134.65pt; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0cm 5.4pt;" valign="top" width="180"> <p style="margin-bottom:0cm;line-height:normal" class="MsoNormal"><span style="font-size: 10pt; color: black;">拢50</span><span style="font-size: 12pt;"></span></p> </td> </tr> </tbody></table><p class="MsoNormal" style="margin-bottom:0cm;line-height:normal"> </p><p style="margin-bottom: 0cm; line-height: normal; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;" class="MsoNormal"><span style="font-size: 10pt;"> </span></p></div></div> <div class="oneField field-container-D " id="tfa_230-D"> <label id="tfa_230-L" class="label preField reqMark" for="tfa_230">Please confirm the tier your annual income sits within:  </label><br><div class="inputWrapper"><select aria-required="true" id="tfa_230" name="tfa_230" title="Please confirm the tier your annual income sits within: " class="required"><option value="">Please select...</option> <option value="tfa_233" id="tfa_233" class="">拢2 million + </option> <option value="tfa_234" id="tfa_234" class="">拢1 - 2 million</option> <option value="tfa_235" id="tfa_235" class="">拢100,000 - 拢1 million</option> <option value="tfa_236" id="tfa_236" class="">拢10,000 - 拢100,000</option> <option value="tfa_237" id="tfa_237" class="">Up to 拢10,000</option></select></div> </div> <div class="oneField field-container-D " id="tfa_242-D"> <label id="tfa_242-L" class="label preField reqMark" for="tfa_242">Preferred method of payment (if approved)</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_242" multiple name="tfa_242[]" title="Preferred method of payment (if approved)" class="required"><option value="">Please select...</option> <option value="tfa_243" id="tfa_243" class="">Card payment</option> <option value="tfa_244" id="tfa_244" class="">International bank transfer</option> <option value="tfa_245" id="tfa_245" class="">Not sure</option></select></div> </div> </fieldset> <fieldset id="tfa_15" class="section"> <legend id="tfa_15-L"><b>EXECUTIVE BOARD INFORMATION</b></legend> <div id="tfa_93" class="section inline group"> <div class="oneField field-container-D " id="tfa_232-D"> <label id="tfa_232-L" class="label preField reqMark" for="tfa_232">First Name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_232" name="tfa_232" value="" title="First Name" class="required"></div> </div> <div class="oneField field-container-D " id="tfa_17-D"> <label id="tfa_17-L" class="label preField reqMark" for="tfa_17">Last Name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_17" name="tfa_17" value="" title="Last Name" class="required"></div> </div> </div> <div id="tfa_95" class="section inline group"> <div class="oneField field-container-D " id="tfa_66-D"> <label id="tfa_66-L" class="label preField " for="tfa_66">Email</label><br><div class="inputWrapper"><input type="text" id="tfa_66" name="tfa_66" value="" title="Email" class="validate-email"></div> </div> <div class="oneField field-container-D " id="tfa_18-D"> <label id="tfa_18-L" class="label preField " for="tfa_18">Role on the Executive Board</label><br><div class="inputWrapper"><select id="tfa_18" name="tfa_18" title="Role on the Executive Board" class=""><option value="">Please select...</option> <option value="tfa_212" id="tfa_212" class="">President</option> <option value="tfa_213" id="tfa_213" class="">Vice-President</option> <option value="tfa_214" id="tfa_214" class="">Treasurer</option> <option value="tfa_215" id="tfa_215" class="">Secretary</option> <option value="tfa_216" id="tfa_216" class="">Board Member</option> <option value="tfa_217" id="tfa_217" data-conditionals="#tfa_218" class="">Other</option></select></div> </div> <div class="oneField field-container-D " id="tfa_19-D"> <label id="tfa_19-L" class="label preField " for="tfa_19">Position</label><br><div class="inputWrapper"><select id="tfa_19" name="tfa_19" title="Position" class=""><option value="">Please select...</option> <option value="tfa_144" id="tfa_144" class="">Researcher</option> <option value="tfa_145" id="tfa_145" class="">Bariatric surgeon</option> <option value="tfa_146" id="tfa_146" class="">Cardiologist</option> <option value="tfa_147" id="tfa_147" class="">Consultant Dietitian</option> <option value="tfa_148" id="tfa_148" class="">Diabetes educators</option> <option value="tfa_149" id="tfa_149" class="">Diabetologist</option> <option value="tfa_150" id="tfa_150" class="">Bariatric physician</option> <option value="tfa_151" id="tfa_151" class="">Endocrinologist</option> <option value="tfa_152" id="tfa_152" class="">Media Advocate</option> <option value="tfa_153" id="tfa_153" class="">Medical officer</option> <option value="tfa_154" id="tfa_154" class="">Nurse</option> <option value="tfa_155" id="tfa_155" class="">Nutritionist</option> <option value="tfa_156" id="tfa_156" class="">Paediatric endocrinologist</option> <option value="tfa_157" id="tfa_157" class="">Physiotherapist</option> <option value="tfa_158" id="tfa_158" class="">Paediatrician</option> <option value="tfa_159" id="tfa_159" class="">Physician</option> <option value="tfa_160" id="tfa_160" class="">Psychologist</option> <option value="tfa_161" id="tfa_161" class="">Population Health Expert</option> <option value="tfa_162" id="tfa_162" class="">Public Health Advisor</option> <option value="tfa_163" id="tfa_163" data-conditionals="#tfa_227" class="">Other</option></select></div> </div> <div class="oneField field-container-D " id="tfa_218-D"> <label id="tfa_218-L" class="label preField " for="tfa_218">Specify Other (Role)</label><br><div class="inputWrapper"><input type="text" id="tfa_218" name="tfa_218" value="" data-condition="`#tfa_217`" title="Specify Other (Role)" class=""></div> </div> <div class="oneField field-container-D " id="tfa_227-D"> <label id="tfa_227-L" class="label preField " for="tfa_227">Specify Other (Position)</label><br><div class="inputWrapper"><input type="text" id="tfa_227" name="tfa_227" value="" data-condition="`#tfa_163`" title="Specify Other (Position)" class=""></div> </div> </div> <div class="oneField field-container-D " id="tfa_116-D" role="group" aria-labelledby="tfa_116-L" data-tfa-labelledby="-L tfa_116-L"> <label id="tfa_116-L" class="label preField " data-tfa-check-label-for="tfa_116">Is this also the Administrative point of contact?</label><br><div class="inputWrapper"> <span id="tfa_116" class="choices vertical "><span class="oneChoice"><input type="checkbox" value="tfa_117" class="" id="tfa_117" name="tfa_117" aria-labelledby="tfa_117-L" data-tfa-labelledby="tfa_116-L tfa_117-L" data-tfa-parent-id="tfa_116" aria-describedby="tfa_116-HH"><label class="label postField" id="tfa_117-L" for="tfa_117"><span class="input-checkbox-faux"></span>Yes</label></span><span class="oneChoice"><input type="checkbox" value="tfa_118" class="" id="tfa_118" name="tfa_118" data-conditionals="#tfa_30" aria-labelledby="tfa_118-L" data-tfa-labelledby="tfa_116-L tfa_118-L" data-tfa-parent-id="tfa_116" aria-describedby="tfa_116-HH"><label class="label postField" id="tfa_118-L" for="tfa_118"><span class="input-checkbox-faux"></span>No</label></span></span><span class="field-hint-inactive" id="tfa_116-H"><span id="tfa_116-HH" class="hint">If No please fill in the POC ADMINISTRATOR INFORMATION section below</span></span> </div> </div> </fieldset> <fieldset id="tfa_74" class="repeat section" data-repeatlabel="Add More Executives"> <legend id="tfa_74-L"><b>EXECUTIVE BOARD INFORMATION</b></legend> <div id="tfa_94" class="section inline group"> <div class="oneField field-container-D " id="tfa_75-D"> <label id="tfa_75-L" class="label preField reqMark" for="tfa_75">First Name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_75" name="tfa_75" value="" title="First Name" class="required"></div> </div> <div class="oneField field-container-D " id="tfa_76-D"> <label id="tfa_76-L" class="label preField reqMark" for="tfa_76">Last Name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_76" name="tfa_76" value="" title="Last Name" class="required"></div> </div> </div> <div id="tfa_98" class="section inline group"> <div class="oneField field-container-D " id="tfa_80-D"> <label id="tfa_80-L" class="label preField " for="tfa_80">Email</label><br><div class="inputWrapper"><input type="text" id="tfa_80" name="tfa_80" value="" title="Email" class="validate-email"></div> </div> <div class="oneField field-container-D " id="tfa_77-D"> <label id="tfa_77-L" class="label preField " for="tfa_77">Role on the Executive Board</label><br><div class="inputWrapper"><select id="tfa_77" name="tfa_77" title="Role on the Executive Board" class=""><option value="">Please select...</option> <option value="tfa_219" id="tfa_219" class="">President</option> <option value="tfa_220" id="tfa_220" class="">Vice-President</option> <option value="tfa_221" id="tfa_221" class="">Treasurer</option> <option value="tfa_222" id="tfa_222" class="">Secretary</option> <option value="tfa_223" id="tfa_223" class="">Board Member</option> <option value="tfa_224" id="tfa_224" data-conditionals="#tfa_225" class="">Other</option></select></div> </div> <div class="oneField field-container-D " id="tfa_78-D"> <label id="tfa_78-L" class="label preField " for="tfa_78">Position</label><br><div class="inputWrapper"><select id="tfa_78" name="tfa_78" title="Position" class=""><option value="">Please select...</option> <option value="tfa_164" id="tfa_164" class="">Researcher</option> <option value="tfa_165" id="tfa_165" class="">Bariatric surgeon</option> <option value="tfa_166" id="tfa_166" class="">Cardiologist</option> <option value="tfa_167" id="tfa_167" class="">Consultant Dietitian</option> <option value="tfa_168" id="tfa_168" class="">Diabetes educators</option> <option value="tfa_169" id="tfa_169" class="">Diabetologist</option> <option value="tfa_170" id="tfa_170" class="">Bariatric physician</option> <option value="tfa_171" id="tfa_171" class="">Endocrinologist</option> <option value="tfa_172" id="tfa_172" class="">Media Advocate</option> <option value="tfa_173" id="tfa_173" class="">Medical officer</option> <option value="tfa_174" id="tfa_174" class="">Nurse</option> <option value="tfa_175" id="tfa_175" class="">Nutritionist</option> <option value="tfa_176" id="tfa_176" class="">Paediatric endocrinologist</option> <option value="tfa_177" id="tfa_177" class="">Physiotherapist</option> <option value="tfa_178" id="tfa_178" class="">Paediatrician</option> <option value="tfa_179" id="tfa_179" class="">Physician</option> <option value="tfa_180" id="tfa_180" class="">Psychologist</option> <option value="tfa_181" id="tfa_181" class="">Population Health Expert</option> <option value="tfa_182" id="tfa_182" class="">Public Health Advisor</option> <option value="tfa_183" id="tfa_183" data-conditionals="#tfa_229" class="">Other</option></select></div> </div> <div class="oneField field-container-D " id="tfa_225-D"> <label id="tfa_225-L" class="label preField " for="tfa_225">Specify Other (Role)</label><br><div class="inputWrapper"><input type="text" id="tfa_225" name="tfa_225" value="" data-condition="`#tfa_224`" title="Specify Other (Role)" class=""></div> </div> </div> <div class="oneField field-container-D " id="tfa_229-D"> <label id="tfa_229-L" class="label preField " for="tfa_229">Specify Other (Position)</label><br><div class="inputWrapper"><input type="text" id="tfa_229" name="tfa_229" value="" data-condition="`#tfa_183`" title="Specify Other (Position)" class=""></div> </div> </fieldset> <fieldset id="tfa_30" class="section" data-condition="`#tfa_118`"> <legend id="tfa_30-L"><b>POC ADMINISTRATOR INFORMATION</b></legend> <div id="tfa_92" class="section inline group"> <div class="oneField field-container-D " id="tfa_31-D"> <label id="tfa_31-L" class="label preField " for="tfa_31">First Name</label><br><div class="inputWrapper"><input type="text" id="tfa_31" name="tfa_31" value="" title="First Name" class=""></div> </div> <div class="oneField field-container-D " id="tfa_32-D"> <label id="tfa_32-L" class="label preField " for="tfa_32">Last Name</label><br><div class="inputWrapper"><input type="text" id="tfa_32" name="tfa_32" value="" title="Last Name" class=""></div> </div> </div> <div id="tfa_207" class="section inline group"> <div class="oneField field-container-D " id="tfa_35-D"> <label id="tfa_35-L" class="label preField " for="tfa_35">Email</label><br><div class="inputWrapper"><input type="text" id="tfa_35" name="tfa_35" value="" title="Email" class="validate-email"></div> </div> <div class="oneField field-container-D " id="tfa_33-D"> <label id="tfa_33-L" class="label preField " for="tfa_33">Position</label><br><div class="inputWrapper"><select id="tfa_33" name="tfa_33" title="Position" class=""><option value="">Please select...</option> <option value="tfa_187" id="tfa_187" class="">Researcher</option> <option value="tfa_188" id="tfa_188" class="">Bariatric surgeon</option> <option value="tfa_189" id="tfa_189" class="">Cardiologist</option> <option value="tfa_190" id="tfa_190" class="">Consultant Dietitian</option> <option value="tfa_191" id="tfa_191" class="">Diabetes educators</option> <option value="tfa_192" id="tfa_192" class="">Diabetologist</option> <option value="tfa_193" id="tfa_193" class="">Bariatric physician</option> <option value="tfa_194" id="tfa_194" class="">Endocrinologist</option> <option value="tfa_195" id="tfa_195" class="">Media Advocate</option> <option value="tfa_196" id="tfa_196" class="">Medical officer</option> <option value="tfa_197" id="tfa_197" class="">Nurse</option> <option value="tfa_198" id="tfa_198" class="">Nutritionist</option> <option value="tfa_199" id="tfa_199" class="">Paediatric endocrinologist</option> <option value="tfa_200" id="tfa_200" class="">Physiotherapist</option> <option value="tfa_201" id="tfa_201" class="">Paediatrician</option> <option value="tfa_202" id="tfa_202" class="">Physician</option> <option value="tfa_203" id="tfa_203" class="">Psychologist</option> <option value="tfa_204" id="tfa_204" class="">Population Health Expert</option> <option value="tfa_205" id="tfa_205" class="">Public Health Advisor</option> <option value="tfa_206" id="tfa_206" data-conditionals="#tfa_228" class="">Other</option></select></div> </div> </div> <div class="oneField field-container-D " id="tfa_228-D"> <label id="tfa_228-L" class="label preField " for="tfa_228">Specify Other (Position)</label><br><div class="inputWrapper"><input type="text" id="tfa_228" name="tfa_228" value="" data-condition="`#tfa_206`" title="Specify Other (Position)" class=""></div> </div> </fieldset> <fieldset id="tfa_36" class="section"> <legend id="tfa_36-L"><b>DECLARATION</b></legend> <div class="htmlSection" id="tfa_37"><div class="htmlContent" id="tfa_37-HTML"><b>I declare that:</b></div></div> <div class="oneField field-container-D " id="tfa_38-D" role="group" aria-labelledby="tfa_38-L" data-tfa-labelledby="-L tfa_38-L"> <label id="tfa_38-L" class="label preField reqMark" data-tfa-check-label-for="tfa_38" aria-label="The Organisation is not-for-profit 聽 required">The Organisation is not-for-profit</label><br><div class="inputWrapper"><span id="tfa_38" class="choices vertical required"><span class="oneChoice"><input type="checkbox" value="tfa_39" class="" id="tfa_39" name="tfa_39" aria-labelledby="tfa_39-L" data-tfa-labelledby="tfa_38-L tfa_39-L" data-tfa-parent-id="tfa_38"><label class="label postField" id="tfa_39-L" for="tfa_39"><span class="input-checkbox-faux"></span></label></span></span></div> </div> <div class="oneField field-container-D " id="tfa_40-D" role="group" aria-labelledby="tfa_40-L" data-tfa-labelledby="-L tfa_40-L"> <label id="tfa_40-L" class="label preField reqMark" data-tfa-check-label-for="tfa_40" aria-label="The Organisation has similar objectives to that of WORLD OBESITY 聽 required">The Organisation has similar objectives to that of WORLD OBESITY</label><br><div class="inputWrapper"><span id="tfa_40" class="choices vertical required"><span class="oneChoice"><input type="checkbox" value="tfa_41" class="" id="tfa_41" name="tfa_41" aria-labelledby="tfa_41-L" data-tfa-labelledby="tfa_40-L tfa_41-L" data-tfa-parent-id="tfa_40"><label class="label postField" id="tfa_41-L" for="tfa_41"><span class="input-checkbox-faux"></span></label></span></span></div> </div> <div class="oneField field-container-D " id="tfa_42-D" role="group" aria-labelledby="tfa_42-L" data-tfa-labelledby="-L tfa_42-L"> <label id="tfa_42-L" class="label preField reqMark" data-tfa-check-label-for="tfa_42" aria-label="The Organisation has a minimum of 15 members 聽 required">The Organisation has a minimum of 15 members</label><br><div class="inputWrapper"><span id="tfa_42" class="choices vertical required"><span class="oneChoice"><input type="checkbox" value="tfa_43" class="" id="tfa_43" name="tfa_43" aria-labelledby="tfa_43-L" data-tfa-labelledby="tfa_42-L tfa_43-L" data-tfa-parent-id="tfa_42"><label class="label postField" id="tfa_43-L" for="tfa_43"><span class="input-checkbox-faux"></span></label></span></span></div> </div> <div id="tfa_50" class="section inline group"> <div class="oneField field-container-D " id="tfa_46-D" role="group" aria-labelledby="tfa_46-L" data-tfa-labelledby="-L tfa_46-L"> <label id="tfa_46-L" class="label preField reqMark" data-tfa-check-label-for="tfa_46" aria-label="I declare that the information I have provided in the application is truthful. Once the Organisation becomes a member, it agrees to pay the annual membership fee requested by WORLD OBESITY 聽 required">I declare that the information I have provided in the application is truthful. Once the Organisation becomes a member, it agrees to pay the annual membership fee requested by WORLD OBESITY</label><br><div class="inputWrapper"><span id="tfa_46" class="choices vertical required"><span class="oneChoice"><input type="checkbox" value="tfa_47" class="" id="tfa_47" name="tfa_47" aria-labelledby="tfa_47-L" data-tfa-labelledby="tfa_46-L tfa_47-L" data-tfa-parent-id="tfa_46"><label class="label postField" id="tfa_47-L" for="tfa_47"><span class="input-checkbox-faux"></span></label></span></span></div> </div> <div class="oneField field-container-D " id="tfa_48-D"> <label id="tfa_48-L" class="label preField reqMark" for="tfa_48">Applicant Name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_48" name="tfa_48" value="" title="Applicant Name" class="required"></div> </div> <div class="oneField field-container-D " id="tfa_51-D"> <label id="tfa_51-L" class="label preField reqMark" for="tfa_51">Role of signatory</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_51" name="tfa_51" value="" title="Role of signatory" class="required"></div> </div> </div> <div id="tfa_100" class="section inline group"> <div class="oneField field-container-D " id="tfa_49-D" role="group" aria-labelledby="tfa_49-L" data-tfa-labelledby="-L tfa_49-L"> <label id="tfa_49-L" class="label preField reqMark" data-tfa-check-label-for="tfa_49" aria-label="Applicant Signature 聽 required">Applicant Signature</label><br><div class="inputWrapper"><span id="tfa_49" class="choices vertical required"><span class="oneChoice"><input type="checkbox" value="tfa_104" class="" id="tfa_104" name="tfa_104" aria-labelledby="tfa_104-L" data-tfa-labelledby="tfa_49-L tfa_104-L" data-tfa-parent-id="tfa_49"><label class="label postField" id="tfa_104-L" for="tfa_104"><span class="input-checkbox-faux"></span></label></span></span></div> </div> <div class="oneField field-container-D " id="tfa_52-D"> <label id="tfa_52-L" class="label preField reqMark" for="tfa_52">Date</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_52" name="tfa_52" value="" autocomplete="off" min="+|0_Day{}" max="+|0_Day{}" title="Date" class="validate-datecal required"></div> </div> </div> </fieldset> <fieldset id="tfa_53" class="section"> <legend id="tfa_53-L"><b>REQUIRED DOCUMENTATION</b></legend> <div class="htmlSection" id="tfa_54"><div class="htmlContent" id="tfa_54-HTML"><u><i>Please ensure that the following documentation is included with the completed application form:</i></u></div></div> <div id="tfa_109" class="section inline group"> <div class="htmlSection" id="tfa_111"><div class="htmlContent" id="tfa_111-HTML">Official request to apply for WORLD OBESITY National or Associate membership on behalf of the Executive Committee of the applying Association </div></div> <div class="oneField field-container-D " id="tfa_110-D"> <label id="tfa_110-L" class="label preField reqMark" for="tfa_110">Letter from the president</label><br><div class="inputWrapper"><input type="file" aria-required="true" id="tfa_110" name="tfa_110" size="" title="Letter from the president" class="required"></div> </div> </div> <div class="htmlSection" id="tfa_114"><div class="htmlContent" id="tfa_114-HTML">Association's articles of association</div></div> <div class="oneField field-container-D " id="tfa_106-D"> <label id="tfa_106-L" class="label preField reqMark" for="tfa_106">Articles of Association document</label><br><div class="inputWrapper"><input type="file" aria-required="true" id="tfa_106" name="tfa_106" size="" title="Articles of Association document" class="required"></div> </div> </fieldset> <div class="htmlSection" id="tfa_89"><div class="htmlContent" id="tfa_89-HTML"><b style="text-decoration-line: underline;">Alternatively you can send the application and supporting documents to:</b><br><br><u>Membership@worldobesity.org</u><br><br>Once the application form and associated documents have been received, The Membership Committee, <br>will review the application, it will be then be referred to the Executive Committee with a recommendation <br>to accept or reasons to reject the application. If further information is required you will be contacted.<br>Your application should take a maximum of 2 months to process.<br><br><b>Please note that WORLD OBESITY will not be able to process incomplete applications or those missing required documents</b></div></div> <div class="actions" id="4888813-A" data-contentid="submit_button"> <div id="google-captcha" style="display: none"> <br><div class="captcha"> <div class="oneField"> <div class="g-recaptcha" id="g-recaptcha-render-div"></div> <div class="g-captcha-error"></div> <br> </div> <div class="captchaHelp">reCAPTCHA helps prevent automated form spam.<br> </div> <div id="disabled-explanation" class="captchaHelp" style="display: none">The submit button will be disabled until you complete the CAPTCHA.</div> </div> </div> <input type="submit" data-label="Submit" class="primaryAction" id="submit_button" value="Submit"> </div> <div style="clear:both"></div> <input type="hidden" value="4888813" name="tfa_dbFormId" id="tfa_dbFormId"><input type="hidden" value="" name="tfa_dbResponseId" id="tfa_dbResponseId"><input type="hidden" value="6a896232c0aa7bc1645c56da389a2416" name="tfa_dbControl" id="tfa_dbControl"><input type="hidden" value="" name="tfa_dbWorkflowSessionUuid" id="tfa_dbWorkflowSessionUuid"><input type="hidden" value="" name="tfa_noOverWriteFields" id="tfa_noOverWriteFields"><input type="hidden" value="15" name="tfa_dbVersionId" id="tfa_dbVersionId"><input type="hidden" value="" name="tfa_switchedoff" id="tfa_switchedoff"> </form> </div></div><div class="wFormFooter"><p class="supportInfo"><a target="new" class="contactInfoLink" href="https://www.tfaforms.com/forms/help/4700755" data-testid="contact-info-link">Contact Information</a><br></p></div> <p class="supportInfo" > </p> </div> </div> <script src='https://www.tfaforms.com/js/iframe_message_helper_internal.js?v=2'></script> </body> </html> </div> </div> </div> </div> <div class="social-share-bottom d-md-none"> <div class="container"> <div class="row"> <div class="col-12"> <div class="pt-3 pb-1"> <h4 class="mt-1 mb-1 mr-2 float-left">Share this page</h4> <ul class="share-icons"> <li data-aos="fade" data-aos-offset="100" data-aos-delay="200"><a class="facebook" href="https://www.facebook.com/sharer/sharer.php?u=https://www.worldobesity.org/our-network/apply-to-be-a-member/membership-application-form" target="_blank"><i class="fab fa-facebook-f"></i></a></li> <li data-aos="fade" data-aos-offset="100" data-aos-delay="400"><a class="twitter" href="https://twitter.com/home?status=https://www.worldobesity.org/our-network/apply-to-be-a-member/membership-application-form" target="_blank"><i class="fab fa-twitter"></i></a></li> <li data-aos="fade" data-aos-offset="100" data-aos-delay="600"><a class="linkedin" href="https://www.linkedin.com/shareArticle?mini=true&url=https://www.worldobesity.org/our-network/apply-to-be-a-member/membership-application-form&title=Membership Application Form" target="_blank"><i class="fab fa-linkedin-in"></i></a></li> </ul> </div> </div> </div> </div> </div> </article> </main> <div class="modal modal-site-search" tabindex="-1" role="dialog"> <div class="modal-dialog modal-dialog-centered modal-lg animated fadeIn"> <div class="modal-content"> <form method="post" action="https://www.worldobesity.org/" > <div class='hiddenFields'> <input type="hidden" name="params" value="eyJyZXN1bHRfcGFnZSI6Imh0dHBzOlwvXC93d3cud29ybGRvYmVzaXR5Lm9yZ1wvc2VhcmNoIn0" /> <input type="hidden" name="ACT" value="68" /> <input type="hidden" name="site_id" value="1" /> <input type="hidden" name="csrf_token" value="f6b73f84143815ae2592ca725e09395170d7c1f1" /> </div> <div class="input-group input-group-lg"> <input class="form-control site-search-input input-lg" type="search" name="keywords" value="" placeholder="Search"> <button class="btn btn-outline-secondary" type="submit"><i class="fas fa-search"></i></button> </div> </form> </div> </div> </div> <div class="pre-footer"> <div class="container"> <div class="row"> <div class="col-12 col-md-4"> <div class="card card-trans"> <div class="card-body"> <p class="mb-2"><span class="category small tag">Training & Events</span></p> <h3 class="card-title">SCOPE E-Learning</h3> <p class="card-text mb-0">We offer the only internationally recognised course on obesity management. 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