Form - UHC2030

Organisation Details

1. Official name of organisation *

2. Acronym (if applicable)

3. Former name (if applicable)

4. Legal status *

5. Year established *

6. Address *

7. Town/City *

8. State/Region

9. Post code

10. Country *

11. Main phone number *

12. Email address (generic) *

13. Website

Before You Begin

We estimate this form will take around 30 minutes to complete.
Please ensure you have downloaded, completed and scanned this Tobacco and Arms Disclosure Statement, as you will need to upload it at the end of the form.
You will also need to upload the following supporting documents:
1)Copy of the organisation's legal status
2)Composition of the organisation's decision making body
3) Details of the organisation's sources of funding
4) Details of the organisation's constitution/statutes/by-laws and affiliation.
Documents may be .PDF, .DOC or .DOCX up to 5MB each.