CHF We're #withconsumers Application Form

1 Start 2 Payment

If you would like to use our CHF We’re #withconsumers Tick for your next national or international event, publication or initiative, please complete the form below and allow up to ten working days for a reply.

Name Prefix

First Name *

Last Name *

Name of Organisation *

Street Address

Street Address Line 2

City

Postal Code

State/Province

Country *

Phone Number *

Phone Number 2

Phone Extension 2

Email *

Is your organisation a *

Name of event, publication or initiative claiming the CHF We’rewithconsumers Tick status *

Dates during which you will be using the We'rewithconsumers Tick - Start Date *

Day

Month

Year

End date

Day

Month

Year

Please provide a statement explaining how the Tick will be used. *

Existing Contact

URL of event, publication or initiative claiming the CHF We’rewithconsumers Tick status

Hashtag of event, publication or initiative claiming the CHF We'rewithconsumers Tick status

List examples that demonstrate how the event, publication or initiative is collaborating/engaging with consumers. Please provide evidence, including links. *

Please provide a statement demonstrating how your organisation’s goals align with CHF’s mission and objectives. *

Supporting Documents

Files must be less than 2 MB.
Allowed file types: gif jpg png.

Leave this field blank

Consumers Shaping Health

CHF We're #withconsumers Application Form

You are here

Follow CHF

Get updates from CHF

CHF We're #withconsumers Application Form

You are here

Search form

Follow CHF

Get updates from CHF