Planetary Health Alliance New Member Organization Application

Thank you for your interest in joining the Planetary Health Alliance!

Our team reviews member applications on a monthly basis, so please allow four weeks from your application date to hear back from our team. All prospective members are required to fill out the New PHA Member Application form. To learn more about PHA Membership please read the information on our website (planetaryhealthalliance.org/join) and contact ph_alliance@jhu.edu if you have any questions. We look forward to learning more about your Planetary Health efforts!

Name of Organization Applying for PHA Membership*

Organization Website*

If you do not have a website, please include other relevant links (not including social media).

Organization's physical mailing address*

This allows us to display your location on our membership map.

What country is your organization headquartered in?*

Communications Information

The primary point of contact is the main person responsible for communication between PHA and your organization, followed by the secondary point of contact as needed. These individuals will receive sporadic emails about required member surveys, collective decision-making, and other updates regarding membership and other important PHA activities. We ask that this information be updated whenever your points of contact change, which can be done by emailing ph_alliance@jhu.edu.

Primary Point of Contact

First Name*

Last Name*

Email*

Position/Role*

Secondary Point of Contact

First Name *

Last Name*

Email*

Position*

Social Media Information

If different from the above points of contact, please provide the email(s) of your organization's primary communications/social media contact(s):

X (Twitter) Handle:

Instagram Handle:

Link to Facebook page:

Link to LinkedIn profile:

Link to YouTube channel:

Please include any other communications links (newsletters, blogs, other social media, etc.).

Getting to Know Your Organization

How did you find out about PHA membership? If applicable, please also describe any affiliations to current member(s) of the Alliance or a Planetary Health Regional Hub.*

Please tell us about your organization's mission, structure, scale of operations, and main programmatic activities. In what ways do your mission and activities relate to Planetary Health? Please reference specific examples of how your organization has incorporated Planetary Health to date.*

Please describe 2-3 ways that your organization plans to advance Planetary Health in a) your own network or community, and b) the global Planetary Health Alliance community.*

What does your organization hope to gain from joining the Planetary Health Alliance?*

In what ways could the Planetary Health Alliance staff team and other PHA Members best support your organization's advancement of Planetary Health? Be specific to your organization's current and future activities.*

Final Steps to Formalize Membership

All members are asked to provide a formal Statement of Collaboration, which will be made public to promote collaboration within the Alliance. Using your answers to the previous questions, please write a formal Statement of Collaboration (3-5 sentences) about how your organization incorporates Planetary Health into its work and how you aim to collaborate with the Planetary Health community.*

SOCs will be used on the PHA website, in relevant newsletters, and for internal PHA member matchmaking. You can find example SOCs on the Alliance Member section of our website.

Upload your organization's logo here.*

This will be used on the PHA website and in other communication materials. Preference for horizontal images with no background (browse Alliance Members on our website for examples).

I understand that members may not represent themselves as the Planetary Health Alliance without prior permission, either explicitly or through use of its logo. I understand that member institutions' views are their own and do not represent those of the Planetary Health Alliance or its membership.*

I accept.

I do not accept.

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