HENI Membership form
This is an application form for membership to the Health Equity Network India (HENI). For any query in filling this form, please contact the HENI Coordinator at heni@iphindia.org. For more details on HENI, visit the website www.healthinequity.com
Email *
First name *
Last name *
Name of HENI member who referred you *
Age group *
Gender *
Organisation(s) *
Please enter NA if not affiliated to any organisation
List areas of interest in health equity research *
Use only keywords. Avoid sentences. Separate keywords with commas
How do you engage with health equity research? (multiple responses possible) *
Multiple responses possible
Required
List any health or research networks you belong to (optional)
I declare that I have read the HENI concept document and understand the role of a member in the network *
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