IPSN Membership Form

Please fill in this form to apply for your organization to become a member of the International Pathogen Surveillance Network (IPSN). If your organization is a non-state actor, you will be requested to submit additional information. Please note that individual private sector organizations will need to be represented by private sector business associations and cannot themselves become members. Private sector organizations who would like to receive information on the IPSN may complete this form, but applications will not be forwarded for official membership.

Please reach out to the IPSN Secretariat (IPSN-secretariat@who.int) should you have any questions or would like to receive additional information.

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* Do you confirm that you are entitled to represent your organization in the IPSN and that you have received any necessary authorization from your organization to submit this membership application?

Yes

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* Your organization

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* Your chosen title

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* Your first name

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* Your surname

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* Your email address

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* Your position

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* Please indicate which type of organization you represent. Please note that if your organization is a non-state actor, you will be requested to submit additional information via email.

Governmental organization

Intergovernmental organization

Non-governmental organization

Academic institution

Philanthropic foundation

Private sector

Private sector business association

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* Within which country or territory is your organization based?

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* Within which WHO region is your organization based?

Global

African Region

American Region (North, Central, South America)

Eastern Mediterranean Region

European Region

South East Asian Region

Western Pacific Region

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* The IPSN Terms of Reference (TOR) lay out the terms of membership and describe the governance and operating procedures of the IPSN in more detail. All IPSN members are required to adhere to the TOR. Please confirm below that you have read and accepted the TOR on behalf of your organization.

Please find the IPSN TOR here

Yes

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* IPSN members have access to IPSN platforms, materials, newsletters, partnership and networking opportunities including the annual Global Partners Forum, and potential access to funding opportunities. Please confirm that you would like your organization to become a member of the IPSN.

Yes