Membership Application Form
If you prefer to print the form, please Click Here to download, and mail the form to the address included in the PDF.
2. Principal Contact Person
3. English Language Summary of Your Organization’s Goals and Activities
4. Please make sure you meet the MDS Alliance membership criteria (https://www.mds-alliance.org/become-a-member/)

If you don't meet the criteria please contact us so that we can discuss how to help you.

5. Existing Memberships

Is your organization already a member of other alliances or coalitions?

6. Confirmation and Signature

I hereby confirm that the information given above is accurate, and that my organization is eligible to be a Member of the MDS Alliance as defined above.

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