Application for
Recognition as an ECG Local Chapter “active”
(Step 2)
We hereby apply to change the state of our ECG Local Chapter from “under development” to “active and to be approved as an official ECG Local Chapter.
We have read the “Guidelines to found a regional Local Chapter”.
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Name of Local Chapter |
Add your data here |
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Name of Applicant 1** |
Add your data here |
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Name of Applicant 2** |
Add your data here |
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Name of Applicant 3** |
Add your data here |
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Name of Applicant 4** |
Add your data here |
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Name of Applicant 5** |
Add your data here |
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Street*** |
Add your data here |
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Postal Code, City*** |
Add your data here |
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Country*** |
Add your data here |
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Telephone number*** |
Add your data here |
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Email Address*** |
Add your data here |
* Name of the ECG association which your local chapter is affiliated. If you don’t have an ECG association in your country, please enter “ECG International Federation”.
** These two people will be listed as Local Chapter coordinators.
*** This data will be used as the official address of the Local Chapter.
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City, Date: |
Add your data here |
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Please complete this form and send the Word document to International Reception (international@ecogood.or g).