Membership Application Form

SECTION 1: APPLICANT INFORMATION

Full Name / Organisation Name

Contact Person (if organisation)

Email Address

Phone Number (including country code)

Country / Region of Residence

Postal Address (optional)

SECTION 2: MEMBERSHIP CATEGORY

Please select one option:Basic Member (Individuals and supporters)Family Member (Families with twins or multiple births)Professional Member (Researchers, clinicians, educators, practitioners)Sponsor / Patron Member (Institutions, donors, strategic partners)

SECTION 3: MEMBERSHIP DETAILS
(Complete only the section(s) applicable to you)
A. Family Members

Number of children from multiple births:

Age(s) of children (optional):

B. Professional Members

Profession / Area of Expertise:

Organisation / Institution:

Years of experience (optional):

C. Sponsor / Patron Members

SECTION 4: AREAS OF INTEREST

Please tick all that apply:Research participationEducation and training programmesCommunity and peer supportAdvocacy and policy engagementVolunteering and outreachCommunications and awareness

SECTION 5: COMMUNICATION PREFERENCES

How would you like to receive communications from ATMBRF?EmailSMS / WhatsApp (where applicable)Newsletter onlyEvent invitations

SECTION 6: CONSENT & DECLARATION

Please read and confirm the following:I confirm that the information provided is accurate and complete.I agree to support the mission, values, and objectives of the African Twins and Multiple Births Research Foundation.I understand that participation in research activities requires separate informed consent.I consent to the collection and use of my personal data for membership administration in accordance with ATMBRF’s privacy policy.

Name

Signature:

Date:

SECTION 7: SUBMISSION DETAILS
Online Submission:
Please complete and submit this form via the ATMBRF website.
Print Submission:
Return the completed form via email or to the ATMBRF Secretariat.
You will receive confirmation of membership approval and onboarding details within a specified review period.

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