Membership Registration Form

Thank you for your interest in joining the MPN Advocates Network.

Patient organizations are eligible to apply for membership of MPNAN, as long as they meet the following criteria:

  • Have a sole or significant focus on providing services to and/or supporting patients with Myelofibrosis.
  • Are recognized as a non-profit organisation in good standing in their country.
  • Are willing to work with and cooperate with other member organisations with the same objectives.

If you do not currently meet the criteria for membership but are interested in starting a MPN group in your own country, please email info@mpn-advocates.net 


    Organisation


    Is your organisation legally registered?

    If yes, please enter registration number below:

    Organisation contact






    Organisation main contact person




    Social media - Please, enter links


    Update regularly?
    Open or private portal?



    Update regularly?
    Open or private portal?



    Update regularly?
    Open or private portal?



    Update regularly?
    Open or private portal?



    Update regularly?
    Open or private portal?



    Update regularly?
    Open or private portal?


    Website - Please, enter link

    Please provide a brief description of your organisation, including the programs, activities or services that support patients with MPN:

    Your organisation has experience in the following topics that could contribute to MPNAN:

    How many MPN patients does your organisation support?

    Why should MPNAN accept you as a member of the network?

    Upload the logo of your organisation



    A development program for Blood Cancer Patient Advocates