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Partner Registration Form: World NTD Day 2022
Please register by January 14, 2022 to confirm your intention to participate. For questions please contact
wntdday@unitingtocombatntds.org
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Organization / Company Name
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Contact Name
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Contact Title
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Contact Email Address
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Address
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Telephone (please include country code)
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Website
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Website will be linked from the partner page on
www.worldntdday.org
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Organization logo
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Logo will be highlighted on the partner page on
www.worldntdday.org
. Please enter a URL for the file below, or email us directly.
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Briefly, please explain your organization’s mission or connection with the NTD community
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We agree to support World NTD Day 2022
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We are interested in learning more about and participating in the following activities for World NTD Day 2022:
Advocate and recruit supporters for the Kigali Declaration
Identify and secure landmark to participate in the Light Up campaign
Attend or help organize digital conversation series about NTDs
Nominate high profile individual as ambassador for World NTD Day
Support the day through media outreach in local market
Organize grassroots activities to raise awareness and/or funds for NTDs on World NTD Day
Option 7
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