World Lupus Federation Membership Application

Question Title

* 1. Organization Name

Question Title

* 2. Country of Origin

Question Title

* 3. Is the organization officially recognized as a nonprofit charity organization?

Question Title

* 4. City and state/province of the organization's headquarters location

Question Title

* 5. Does the organization have a board of directors, steering committee or advisory council that meets several times each year to establish goals and action plans, measure progress, approve an annual budget and monitors expenditures?

Yes

No

Question Title

* 6. What is the organization's annual budget?

Question Title

* 7. Does the organization have affiliates, regional sub-groups or local support groups?

Yes

No

Question Title

* 8. Is the organization a member of another Federation or an affiliate of a national or regional coalition?

Yes

No

Question Title

* 9. Organization’s website URL

Question Title

* 10. Organization’s Facebook Page URL

Question Title

* 11. Organization’s Twitter Page URL

Question Title

* 12. Primary Contact Person's Name

Question Title

* 13. Primary Contact Person's Email Address

Question Title

* 14. Additional Contact Person's Name

Question Title

* 15. Additional Contact Person's Email Address