Questions with an asterisk are mandatory
All data provided in the application is kept confidential

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1. I would like to become a member of TBpeople Network. Hereby I confirm that: (Required.)

PERSONAL INFORMATION

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2. First name (Required.)

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3. Surname (Required.)

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4. Middle name

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5. Gender (Required.)

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6. Date of birth (Required.)

Date

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7. Country of residence (Required.)

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8. Town (Required.)

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9. Valid email address (it has to be your own personal email address, not belonging to another person or an organization) (Required.)

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10. Contact telephone number (Required.)

MOTIVATION

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11. Please describe briefly why you are interested in becoming a member of TBpeople. If you are applying for associate membership, please write who of your close ones had TB and how it affected your life. (Required.)

Note: motivation does not affect the decision to whether or not accept you as member of TBpeople. It is important to us as it gives us the understanding of why you are interested in joining TBpeople.

Important: TBpeople is not just an organization, it is a community. That is why we ask our new members to introduce themselves in TBpeople mailing list.

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