INWES Membership Application Form About the person completing this formWe will use this contact information should we have any queries about the application.PrefixMr.Mrs.Ms.Mx.MissDr.Prof.Given NameOther NamesFamily NameYour Telephone *Please enter your full telephone number including the country code.Your Email *Confirmations of receipt of the application will be sent to this email address. PLEASE CHECK IT IS CORRECT.Are you applying on behalf of...? *A NetworkAn InstitutionYourselfAbout the IndividualMore about youYour Street Address *Apartment, suite, etcCity or Town *State/Province *ZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweEmployer/Business/UniversityWhere do you work or study?0 / 80Your job/role/positionPlease explain what your role at the organisation is.0 / 80Are you...?StudentWorking in a less developed countryUnemployed and not a studentSelf-employedRetiredPlease tick all boxes relevant to you. ("Less Developed Countries" are those so defined by the UN)Gender *Female/ identifying as a womanMale/ identifying as a manPrefer not to sayWhat area of STEM do you study/work in?ScienceEngineeringMathematicsMedicineDigital TechnologyBiologyChemistryPhysicsMechanical engineeringCivil engineeringChemical engineeringElectrical engineeringComputer scienceComputer hardwareSoftware developmentStatisticsApplied mathematicsPure mathematicsHealth carePsychologyAnimal healthPlant biologyGender and STEMWomen and leadershipSTEM educationNone of the above but I wish to support INWESPlease tick all boxes relevant to you.Are you known by an existing INWES member?YesNoPlease give the name of the contact and organisation of the INWES member *0 / 100If you belong to other similar organizations, list them here:Are you a member of any other women in STEM group or other network?0 / 250About the Network or InstitutionInformation on the organisationFull name of organization *Please enter your organisation's name as officially known.0 / 100Name of organization in EnglishIf appropriate, please provide a translation of your organisation's name in English.0 / 80Any abbreviation?If your organisation is also known by an abbreviation or shorter name, please provide here.0 / 20Organisation Street Address *Apartment, suite, etcCity or Town *State/Province *ZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabweOrganisation Telephone *Please enter the full telephone number including the country code.Organisation Email *Organisation WebsitePlease enter the website for the organisation for more information on the purpose and goals of the organisation..Size of organisation *upto 5050-499500-4999over 5000Please estimate the number of members in the organisation.Purpose and ActivitiesDescribe very briefly the purpose of the organisation and any key activities.0 / 250Region of operations *Please indicate the coutries or regions in which the organisation operates.0 / 150Is the organisation based in a developing country? *YesNoDon't knowTo see the INWES definition of "developing country", please refer to the INWES webpage on Fees, Payments and Donations.Is the organisation incorporated? i.e. does the organisation have a legal entity? *YesNoDon't knowMost INWES organisational members have a legal status, but this is not a requirement particularly for women in STEM groups.Legal informationPlease explain or if possible, provide details on the legal entity of the organisation. If you do not have this information at this moment, please add here "To be confirmed".0 / 100For invoices, please provide the name, email of person to be contacted and any other information required, such as a Purchase Order Number and another address:0 / 250Invoice to be sent to: *The organization's addressThe address given hereAre you a Key Contact at the organization? *YesNoA Key Contact is someone who can ensure the membership is paid.What is your role at the organisation?Please provide a full job role or position title.What is the role of the Key Contact?Please provide a full job role or position title.PrefixMr.Mrs.Ms.Mx.MissDr.Prof.Given NameOther NamesFamily NameKey Contact Email *Key Contact TelephonePlease enter the full telephone number including the country code.Confirmation of interest in INWES and Data PrivacyAbout your objectives and permission to store your dataPlease TICK to confirm criteria for joining INWES: *I confirm my objectives and goals/our organisation's objectives and purpose are consistent with INWES' mission.Brief reasons for joining INWES, including any INWES activities of interest:Please use this space to explain how you might wish to work with INWES and for any other message.0 / 500Personal Data and GDPR: I confirm I permit INWES to store the above information *I confirm I permit INWES to store the above information.Statement on INWES Privacy Policy and Your DataINWES will never share our members’ nor applicants' for membership data with third parties. By submitting this form you are confirming that you permit INWES to store the above information on the INWES membership database and that you agree with INWES privacy policy. After confirming the above, please click on SUBMIT below. On submission of this form, you will receive an automated email (using the first email address provided) to confirm the application form has been submitted. IN THE CASE "Submit" DOES NOT WORK, please take a screenshot of your filled-in form and forward to membership@www.inwes.org to report the problem.Please allow 14 days for confirmation of receipt at INWES and 30 days before confirmation of eligibility of membership. Please note you may be contacted and asked to provide further information before eligibility membership can be confirmed. Membership is not confirmed until payment of the fees has been confirmed. Thank you!CLICK TO SUBMIT YOUR APPLICATION