Thank you for your interest in membership in the SCTG!

First Name

Last Name

Job Title

City

State/ County/ Province/ District

Country of residence/work United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d’Ivoire Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong S.A.R., China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Virgin Islands Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Viet Nam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe

Email

Phone

Do you consider yourself youth? YesNo

Gender Identity Woman Man Non-binary/Non-conforming Prefer Not to Disclose Prefer to Self-Describe

Membership Type Individual Organization (i.e. joining on behalf of your Organization or as an individual)

Organization Affiliation (If you selected Organization as your Membership Type, enter the Organization name you are affiliated with)

Your Organization Primarily Focus Primary Secondary Does your Organization Primarily focus on Self-Care or Is Self-Care a Secondary cause of your Organization strategy?

Is your Organization a National or Global? Global National

Area of focus (select all that apply) Coalition/Alliance/NetworkGovernment agencyMultilateral agencyFoundationPolicy and/or grassroots advocacyProgram implementerPolicy analysis/think tankProgram/practice researchProduct manufacturing/developmentHealth care institutionProvider associationYouth-focusedPrivate SectorFeminist MovementsOther

If you selected other (area of focus), please specify here:

Reason for membership (select all that apply) NetworkingLearningResearchGlobal/regional advocacyNational/subnational advocacyCommunicationsEvidence to guide program, practice, and policyOther

If you selected other (reason for membership), please specify here:

Self-care resources and expertise you or your organization can provide: Self-care program and practice implementationResearch and analysis on self-careAdvocacy for self-careOther

If you selected other (resources/expertise), please specify here:

If you haven’t done so already, please provide links to any case studies, reports, briefs, etc. that describe your work.

I would like to join the: (To ensure active engagement, we ask that members join at least one working group and/or the SCTG Slack Channel.) Evidence and Learning Working GroupGlobal Advocacy and Communications Working Group Country Advocacy Working GroupSCTG Slack ChannelI do not want to join any SCTG working groups or platforms

Previously signed up for SCTG Membership? Yes No

Previous SCTG Membership Email (If previously signed up for SCTG membership is Yes, enter your previous email address)

Do you agree to follow SCTG Member Bylaws? I agreeI don't agree

Comments

To access SCTG Member Bylaws, click here.