MEMBERSHIP APPLICATION FORM

ASSOCIATION DETAILS

Association Name

Address

Postcode

Country

Association Website

Telephone

Provide brief summary on Mission, Aims or Goals of Association

Membership Eligibility

Please select one or more options to be eligible to join your association

APPLICATION INFORMATION

Which grade of membership would you like to be considered for?

Number of your current members

PLEASE NOTE - MEMBERSHIP FEES ARE BASED ON GROSS ANNUAL INCOME

	WOF Membership Fees
Annual Income	Full Membership (full benefit package + voting)	Associate Membership (limited benefit package/non-voting)
£4 million +	£10000	£5000
£1-4 million	£5000	£2500
£100,000 - £1 million	£1000	£500
£10,000 - £100,000	£300	£150
Up to £10,000	£100	£50

Please confirm the tier your annual income sits within:

Preferred method of payment (if approved)

EXECUTIVE BOARD INFORMATION

First Name

Last Name

Role on the Executive Board

Position

Specify Other (Role)

Specify Other (Position)

Is this also the Administrative point of contact?

YesNoIf No please fill in the POC ADMINISTRATOR INFORMATION section below

EXECUTIVE BOARD INFORMATION

First Name

Last Name

Role on the Executive Board

Position

Specify Other (Role)

Specify Other (Position)

POC ADMINISTRATOR INFORMATION

First Name

Last Name

Position

Specify Other (Position)

DECLARATION

I declare that:

The Organisation is not-for-profit

The Organisation has similar objectives to that of WORLD OBESITY

The Organisation has a minimum of 15 members

I declare that the information I have provided in the application is truthful. Once the Organisation becomes a member, it agrees to pay the annual membership fee requested by WORLD OBESITY

Applicant Name

Role of signatory

Applicant Signature

Date

REQUIRED DOCUMENTATION

Please ensure that the following documentation is included with the completed application form:

Official request to apply for WORLD OBESITY National or Associate membership on behalf of the Executive Committee of the applying Association

Letter from the president

Association's articles of association

Articles of Association document

Alternatively you can send the application and supporting documents to:

Membership@worldobesity.org

Once the application form and associated documents have been received, The Membership Committee,
will review the application, it will be then be referred to the Executive Committee with a recommendation
to accept or reasons to reject the application. If further information is required you will be contacted.
Your application should take a maximum of 2 months to process.

Please note that WORLD OBESITY will not be able to process incomplete applications or those missing required documents

Contact Information