Complete the form below to join the Members-Only section on the #COVIDActionCollab platform. This section will have a number of features like the exchange for materials, and  funding, volunteer listing and members-only toolkit. This will also enable you to connect with other members. Please complete the form to submit your application. We will process the application and respond with your credentials ASAP.

Please note
1. All fields are mandatory
2. This form is for organisations. If you are an individual volunteer, please complete the Volunteer Form.
3. Only one person should complete the form on behalf of an organisation.
4. Only one person from each organisation can register. If you want multiple users from your organisation, please use the same user name and password

Partner/Organisation/Network Name*
Website (Enter the link to the homepage of your organisation)
Partner/Organization/Network Headquarters Location (Country)*
State*
District*
Do you have Branches / Field presence in any other District?*
Branch or Field office Location (Country)*
Branch or Field office State* (Select all that apply, hold Ctrl/Cmd and click to select multiple options)
Branch or Field office District* (Select all that apply, hold Ctrl/Cmd and click to select multiple options)
Partner/Organization/Network Type*
Preferred Language of Communication* (emails, webinars etc. Select all that apply, hold Ctrl/Cmd and click to select multiple options)
Point of Contact (POC) Name *
POC Phone (For WhatsApp)*
POC Email*
What domain(s) do you operate in?* (Select upto 4, hold Ctrl/Cmd and click to select multiple options)
Which communities do you work with?* (Select all that apply, hold Ctrl/Cmd and click to select multiple options)
What response areas can you contribute to?* (Select all that apply, hold Ctrl/Cmd and click to select multiple options)
What resources/partners do you need?* (Select all that apply, hold Ctrl/Cmd and click to select multiple options)
Why do you want to join the collaborative?* (This information will be used to connect you to relevant partners. Max:100 Characters)
What is the total number of people your organisation has the potential to reach?*
How did you find out about us?*
Bio* (This information will be displayed along with your logo in the members section of this website. Max:100 Characters)




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