What is the priority geographic scope of your organizations’ work? (Please note, if you organizations operates globally, please select global and do not specify any region or country.) *
Name and contact information of focal points who will represent the entity in its interactions with the GCM/NCD. (Please nominate at least two and a maximum of three focal points.)
Salutation
Ms
First Name
Kathryn
Last Name
Hodgson
Email
khodgson@ilae.org
Salutation
Dr
First Name
Julie
Last Name
Hall
Email
jhall@ilae.org
Please provide a brief description of your organization, including its aims and objectives. Please limit your description to 100 words.*
The International League Against Epilepsy (ILAE) was founded in 1909 and is an organisation of more than 120 national chapters. It is recognised as the world's preeminent association of health care professionals and scientists working toward a world where no person's life is limited by epilepsy.
I have read the GCM/NCD Engagement Strategy and confirm that my organization is aligned with the principles and priority areas of the engagement strategy. *
On
Is your entity, or was your entity over the last four years, part of the tobacco or arms industries (as defined above)?
No
To the best of your entity’s knowledge, is your entity, or has your entity over the last four years, engaged in activities that
No
To the best of your entity’s knowledge, does your entity currently, or did your entity over the last four years, have any other
No
I am authorized by my organization or entity to submit this application on its behalf and further respond to questions and provide documentation to become a GCM Participant. *
On
The information and documentation is accurate and complete to the best of my knowledge. *
On
I understand that completing this form does not guarantee that my organization or entity will be accepted as a GCM Participant. *
On
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