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Organizational Partner Sign-up for the GCCHE
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* Indicates required question
Name of Organization
*
Your answer
In which country is your organization primarily based?
*
Your answer
Primary Contact Person
*
Your answer
Primary Contact Person's Email Address
*
Your answer
Title/Role in Organization
*
Your answer
Organization Web Address
*
Your answer
Short Description of Organization's Mission/Goals
*
Your answer
Is your organization currently engaged in activities that involve the intersection of health and climate change?
*
Yes
No
Other:
How would you like to participate in GCCHE activities?
Your answer
In what ways can the GCCHE support your organization?
Your answer
Alternative/Communications Contact person
Your answer
Alternative/Communications Contact email address
Your answer
Twitter handle for organization (if applicable)
Your answer
Blue Sky handle for organization (if applicable)
Your answer
Instagram handle for organization (if applicable)
Your answer
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