WHPC Chapter Application
Email address *
2. Have you previously applied to be a WHPC Chapter? *
3. If you answered 'Yes' to the previous question, please provide more information (see guidance)
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4. Please provide the name(s) and postal registered address(es) of the participating organisation(s) involved in this application *
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5. What type of organisation(s) are involved? *
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6. Why do you wish to become a WHPC Chapter?
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7. What are your goals as a WHPC Chapter? *
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8. Please explain the steps taken to define your goals and the people involved. *
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9. How will you monitor and assess the success of your activities? *
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10. Do you have managerial support for your activities? *
11. How do you intend to engage with WHPC and promote WHPC’s vision and goals? *
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12 (a). Name of primary contact for your proposed Chapter: *
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12 (b). Is the primary contact a WHPC individual member? *
12 (c). Email address of primary contact: *
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12 (d). Mailing address of primary contact:
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12 (e). Name of secondary contact for your proposed Chapter: *
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12 (f). Is the secondary contact a WHPC individual member? *
12 (g). Email address of secondary contact: *
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12 (h). Mailing address of secondary contact:
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13. We strongly recommend having a total of five people involved in a Chapter, but are aware that this is not always possible. If you do have additional names to include in your application, please do so below, along with their email addresses.
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14. I understand that there will be an obligation to send WHPC an annual 1-page (minimum) report. This report will include a description of the past year's activities, and a description of the planned activities for the coming year, and the data collected with the standard WHPC data collection tools. *
Required
15. I acknowledge that if successful that I/we will provide an email address that can be shared publicly on the WHPC website. *
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16. I acknowledge that I have authorisation to apply on behalf of the organisation(s) named above. *
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A copy of your responses will be emailed to the address you provided.
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