ACORCA Membership Application

1. Membership Type

2. Details

3. Review & Submit

Membership Information

ACORCA offers several membership types to accommodate different organizations and individuals:

African Institution: $50/year for institutions based in Africa
African Individual: $25/year for individuals based in Africa
Observer Institution: $200/year for non-African institutions
Observer Individual: $50/year for non-African individuals

Fee waivers are available for eligible applicants. Learn more about membership types and fee waivers

Membership Type

Type of membership required

African Institution Information

Name of institution

Type of institution

Focus areas of institution

Research

Research & policy or advocacy

Advocacy or Policy

Clinical

Other (specify)

African Country that institution is based in

Non-African institutions can apply for Observer status

Number of staff involved in Abortion research or policy advocacy

Reason for wanting to join ACORCA

Will your institution be willing to pay the $50/year membership fee?

Yes

Would you like to request a fee waiver?

Yes

Please explain why you would like to request a waiver

View fee waiver criteria

Primary Contact Information

Name of person applying on behalf of institution

Email contact of person applying on behalf of institution

Age of person applying on behalf of institution

Sex of person applying on behalf of institution

Male

Female

Non-binary

Details of up to 5 other staff members who would like to be involved in the work of the Coalition

Staff Member 1

Staff Member 2

Staff Member 3

Staff Member 4

Staff Member 5

Details of where the member registration invoice or payment link should be sent (email and name)

African Individual Information

Name of individual applying

Type of institution you are based in

What is your main focus area?

Research

Research & policy or advocacy

Advocacy or Policy

Clinical

Other (specify)

Which African country are you based in?

What is your nationality?

Reason for wanting to join ACORCA

Are you willing to pay the $25/year individual membership fee?

Yes

Would you like to request a fee waiver?

Yes

Please explain why you would like to request a waiver

View fee waiver criteria

Age

Sex

Male

Female

Non-binary

Email contact

Observer Institution Information

Name of institution

Type of institution

Focus areas of institution

Research

Research & policy or advocacy

Advocacy or Policy

Clinical

Other (specify)

Country that institution is based in

Number of staff involved in Abortion research or policy advocacy

Reason for wanting to join ACORCA

Will your institution be willing to pay the $200/year institutional observer membership fee?

Yes

Primary Contact Information

Name of person applying on behalf of institution

Email contact of person applying on behalf of institution

Age of person applying on behalf of institution

Sex of person applying on behalf of institution

Male

Female

Non-binary

Details of up to 5 other staff members who would like to be involved

Staff Member 1

Staff Member 2

Staff Member 3

Staff Member 4

Staff Member 5

Details of where the member registration invoice or payment link should be sent (email and name)

Observer Individual Information

Name of individual applying

Type of institution you are based in

What is your main focus area?

Research

Research & policy or advocacy

Advocacy or Policy

Clinical

Other (specify)

Which country are you based in?

What is your nationality?

Reason for wanting to join ACORCA

Will you be willing to pay the $50/year individual observer membership fee?

Yes

Would you like to request a fee waiver?

Yes

Please explain why you would like to request a waiver

View fee waiver criteria

What is your email?

Age

Sex

Male

Female

Non-binary

Review Your Application

Please review your information before submitting.

I confirm that all information provided is accurate and complete to the best of my knowledge.