Confederation of Meningitis Organisations Inc (Como)

Confederation of Meningitis Organisations Inc (CoMO)

MEMBERSHIP APPLICATION FORM

We are delighted that you are interested in joining the Confederation of Meningitis Organisations (CoMO) international network. Becoming a CoMO Member means that you will be invited to participate in important awareness raising events worldwide, such as World Meningitis Day and attend CoMO Regional and Global Conferences. CoMO Membership also allows you access to a wealth of capacity building support. Your organisation will be listed as a member on the CoMO website. As a CoMO member, you will also have the opportunity to contribute to policy making at an international level. For further information about CoMO visit our web site www.comomeningitis.org

We look forward to receiving your application form. For further details about how to apply, please see below:

Next steps:

1.  Please send the following information to :

i.  Completed application form below

ii. If you are a registered charity- proof of registration and hi res version of your charity logo

iii.  If you are an individual- a hi res photo of you for inclusion on our website (this is optional)

2.  CoMO will confirm receiving your application within 1 week of receipt. Following receipt of the application, you may be contacted by the CoMO administration for more information. Once all the information has been supplied your application will be sent to the CoMO Governing Council and assessed. This process takes three to six weeks.

Please note:

1.  If it is not possible to complete this form in Word, or you prefer to complete it by hand, please write in clear BLOCK CAPITALS and scan in or return by post to: Confederation of Meningitis Organisations, Newminster House, Baldwin Street, Bristol, BS1 1LT, UK. If you have any queries regarding the membership process, please contact us by emailing Miss Sam Rosoman or by calling Tel +44 333 405 6264 and we will be pleased to help you.

Chris Head – President

CONFEDERATION OF MENINGITIS ORGANISATIONS Inc (CoMO)

a. Type of Membership

CoMO has three categories of membership: Full Members, Associate Members and Friends. If you are unsure which type is right for you, please click here for more info.

Please tick which type of membership you are applying for:

i.  Full Member

ii.  Associate Member

iii.  Friend

b.  For completion by those applying for Full and Associate Membership:

Organisation Details
Organisation Name:
(in English)
Organisation Name:
(in your national or regional language)
Acronym: (e.g. EFCCA)
Organisation area: (please select one) / Asia Pacific
Europe/Africa
Americas
Organisation Address:
Year Established:
Charity Number (if applicable):
Number of Staff:
Number of Volunteers:
Number of beneficiaries
(or members if applicable):
General Email Address:
Website:
Telephone Number: (with country code)
Facebook Page:
Twitter Page:
Logo: / Please attach a copy of your organisation’s logo
Why would you like to become a member of CoMO?: (Please include what benefit you see in membership to your organization)
About your organisation: (Please let us know in detail about the work of your organisation. Include as an attachment if more space is required).
Please include a profile you would like displayed on our website (approx. 100 words), examples of other member profiles can be found here:
http://www.comomeningitis.org/join-us/find-a-member-in-your-country/
Your profile should explain how what you do impacts on meningitis.
Details of your representative:
Please give the details of the person who will:
·  Receive communications from CoMO
·  Respond to consultations where relevant for your organisation
The CoMO Representative should be a Chief Executive, a member of the governing body or a senior manager. Alternatively if you are applying to be a Friend of CoMO, this is your personal information.
Name:
Title (Miss/Mr/Mrs/Dr/Prof):
Position:
Direct Email Address (if possible):
Direct Telephone (if possible):
Link to personal Facebook profile: (this is to enable us to add you to our private Global and Regional CoMO Members’ Facebook Groups. CoMO HQ will add you as a ‘friend’ on Facebook.

For completion by those applying to become a Friend of CoMO:

Name:
Title (Miss/Mr/Mrs/Dr/Prof):
Profile Photo: (this is a professional photo of you for use on our website- this is an optional requirement)
Position:
Address:
Direct Email Address (if possible):
Direct Telephone (if possible):
Link to personal Facebook profile: (this is to enable us to add you to our private Global and Regional CoMO Members’ Facebook Groups. CoMO HQ will add you as a ‘friend’ on Facebook.
Why would you like to become a member of CoMO?
How did you hear about CoMO?
What do you hope to gain/give from your membership?
Please provide a brief profile for use on our CoMO website members section (approx.. 100 words)
Examples: http://www.comomeningitis.org/join-us/find-a-member-in-your-country/europe-africa-regional-members/friends/

Membership Types

Full Membership

A. Criteria

To qualify for full membership, the applicant should:

·  Be significantly focused on overcoming meningitis and/or septicaemia as evidenced by the vision and mission of the organisation. The applicant organization may also operate with and/or on behalf of others (as in a network for example) for the purpose of representing meningitis in any of its forms.

·  Be registered in the relevant national territory with a relevant regulatory authority, and be able to demonstrate this registration. Alternatively the organisation must be directly linked with a relevant registered organisation

·  Be a patient-led or professional organisation

·  Be a non-profit and non-governmental organisation

·  Operate independently of any commercial organisation operating in the meningitis arena including the vaccine manufacturers. For avoidance of doubt, a member can receive funding from such commercial organisations but it must not be controlled or directed by them

·  Be able to meet the duties of a full member (defined below)

B. Benefits

Full Members of CoMO will:

·  Have one deliberate vote.

·  Receive up-to-date information about CoMO member organisations and any other relevant material

·  Be recognised as a Full Member on the CoMO website

·  Have information about the member organisation included in any CoMO displays/at conferences

·  Be authorized to display a certificate of CoMO membership

·  Be invited to attend CoMO conferences and the Annual General Meeting

·  Benefit from subsidies for attending meetings if CoMO may give from time to time

·  Be able to take part in discussions and decision-making at the Annual General Meeting on the basis of one vote per full member organisation

·  Be eligible to apply for funding in accordance with the related guidelines from the Small Grants Programme and/or for any other grants that CoMO may offer from time to time

·  Have access to all resources & toolkits developed by CoMO to support members

·  Be eligible to seek a “buddy” from amongst the other Full Members

·  Receive all CoMO general communications including the newsletter and any communication for all voting members

·  Have the opportunity to request items to be included on the CoMO website and in the CoMO newsletter in accordance with relevant guidelines.

C. Duties

Full Members are required to:

·  Make an annual public statement about work undertaken by the member organisation, and make this available to CoMO

·  Sign up to CoMO’s vision and mission and publicly acknowledge membership of CoMO on all relevant material

·  Confirm annually that they still meet the criteria for full membership and renew their commitment to membership

·  Support activities such as World Meningitis Day. CoMO recognises that every member organisation will have limited time and resources

·  When possible, attend Regional Meeting conference calls and in-person Regional Meetings

·  Pay the annual Full Membership subscription (not applicable at this time)

·  Behave in a manner not to bring CoMO into disrepute

·  Commit to key principles of CoMO membership, which include

o  Working for the good of all members

o  Sharing best practice and resources whilst recognising the need to protect intellectual property

o  Not utilising information gained through CoMO (or from any member of CoMO) for your own organisation’s benefit if it has a detrimental effect on CoMO or another member

o  Recognising that conflicts of interest may arise and declaring them at the earliest opportunity

Associate Membership

a. Criteria

To qualify for Associate Membership, the applicant should:

Organisations

·  Have an interest in overcoming meningitis and/or septicaemia, which can be evidenced through the vision and mission of the organisation, and in expanding that interest to a significant focus in order to become a Full Member within two years of joining as an Associate Member

·  Be registered in the relevant national territory with a relevant regulatory authority; if so, be able to demonstrate this registration, or alternatively must be directly linked with a relevant registered organisation or institution

·  Be patient-orientated or a professional organisation

·  Be a non-profit and non-governmental organisation

·  Operate independently of any commercial organisation operating in the meningitis arena including the vaccine manufacturers. For avoidance of doubt, an associate member can receive funding from such commercial organisations but it must not be controlled or directed by them

·  Be able to meet the responsibilities of an organisation Associate Member (defined below)

Individuals

·  Be seeking to establish a meningitis focused organisation that would qualify for Full Membership once formed

·  Be seeking to form such an organisation within two years of joining CoMO as an Associate Member

·  Be able to meet the responsibilities of an individual Associate Member (defined below)

B. Benefits

Associate Members will:

·  Be recognised as an Associate Member on the CoMO website

·  Be able to display a certificate of CoMO Associate membership

·  Receive all CoMO general communications including the Newsletter

·  Be invited to the annual conference and the Annual General Meeting

·  Have access to all resources & toolkits developed by CoMO to support member development

·  Be eligible to seek a “buddy” from amongst the Full Members in order for an individual to establish a patient support group or for an organisation to expand their mission

C. Duties

Associate members are required to:

Organisations

·  Make an annual public statement about work undertaken by the organisation and make this available to CoMO

·  Sign up to CoMO’s aims and vision, and acknowledge publicly their CoMO membership on all relevant material

·  Confirm annually that they still meet the criteria for associate membership and renew their commitment to membership

·  Develop their mission within two years such that they are eligible to progress to Full Membership. If this has not happened, the Associate Member will become a “Friend” of CoMO and will be encouraged to join and/or support a Full Member

·  Behave in a manner not to bring CoMO into disrepute

·  Pay the annual Associate Membership subscription (not applicable at this time)

Individuals

·  Form a meningitis patient group within two years of becoming an Associate Member. If this has not happened, the individual will become a “Friend” of CoMO and will be encouraged to join and/or support a Full Member a “Friend of CoMO”

·  Behave in a manner not to bring CoMO into disrepute

·  Pay the annual Associate Membership subscription (not applicable at this time)

Friend

a. Criteria

A Friend of CoMO is required to:

·  Be involved in the fight against meningitis and septicaemia willing to show this publicly

·  Support and/or work with a Full or Associate Member of CoMO in their country and/or with CoMO itself.

B. Benefits

Friends of CoMO have the following benefits:

·  Receive all CoMO general communications including the Newsletter

·  Be put in contact with a local, regional and national CoMO member(s) where they exist

·  Be invited to the annual conference

·  Be recognised as a Friend on the CoMO website

Friends have no voting rights, unless elected to the Governing Council.

C. Duties

Friends of CoMO have the following duties:

·  Behave in a manner not to bring CoMO into disrepute

·  Pay the annual Friend Membership subscription (not applicable at this time)

I confirm that the information above is accurate, and that my organisation is eligible to be a Full, Associate Member or Friend as defined above, and is committed to the eradication of Meningitis and Septicaemia

Signed:

______

Name:

Job Title:

Date:

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