Application Details

Contact Details

Request Received
Organization membership reaffirmation
This is a Lifetime membership
This membership includes Unlimited member slot(s)

This form is for reaffirming your agreement with–and commitment to–the Core Principles, Code of Conduct and Accountability Standards of MenEngage Alliance.


To find out more about this process, please read the page: Important information about the updated Core Principles and Code of Conduct​.


This form is for members of MenEngage Alliance. If you are not a member, or you are not sure about your membership status, please email networks@menengage.org.


As a decentralized network, the process varies slightly depending on the regional MenEngage network that you are part of (if any). This means that the deadline for signing these documents will vary per region. Please check the email you received about this to find out the deadline that applies to you.


Before completing the form below, carefully review the following documents:

Glue Up account creation information.

Please enter a first name
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Please enter a last name
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・8 characters minimum
・one upper case letter
・one lower case letter
・one number
・one special character (@$!%*?&)
If you input more than 0 characters your Password may not display properly


・8 characters minimum
・one upper case letter
・one lower case letter
・one number
・one special character (@$!%*?&)
If you input more than 0 characters your Confirm password (at least 8 characters) may not display properly

Please fill in your individual information.

Please fill in the below form with your company details.

Please enter a company name

If you input more than 0 characters your Shortened Name may not display properly
Please enter a value for the other option. The value cannot exceed 255 characters.
Maximum limit reached (255 characters).

If you input more than 0 characters your Other Network Affiliations may not display properly
Please enter a value for the other option. The value cannot exceed 255 characters.
Please enter a value for the other option. The value cannot exceed 255 characters.
Please enter a value for the other option. The value cannot exceed 255 characters.
Please enter a value for the other option. The value cannot exceed 255 characters.

If you input more than 0 characters your Country registered may not display properly

If you input more than 0 characters your Registration number may not display properly

If you input more than 0 characters your Registered address may not display properly
Head of Organization

If you input more than 0 characters your Name (head of organization) may not display properly

Please enter a valid phone number including country code
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Primary focal point

If you input more than 0 characters your Name of Primary focal point to MenEngage Alliance may not display properly

Please enter a valid phone number including country code
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Secondary focal point (if any)

If you input more than 0 characters your Name of Secondary focal point to MenEngage Alliance may not display properly

Please enter a valid phone number including country code
If you input more than 0 characters your Phone Number (primary focal point) may not display properly

Please enter a valid url
e.g. https://menengage.glueup.com
If you input more than 0 characters your Website may not display properly

Please enter a valid Facebook link e.g. "https://www.facebook.com/yourname"
If you input more than 0 characters your Facebook may not display properly

Please enter a valid Instagram Link e.g. "https://www.instagram.com/username"
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Please enter a valid LinkedIn link e.g. "https://www.linkedin.com/in/userid"
If you input more than 0 characters your LinkedIn may not display properly

Please enter a valid Twitter link e.g. "https://www.twitter.com/name"
If you input more than 0 characters your X (aka Twitter) may not display properly

Please enter a valid YouTube Link e.g. "https://www.youtube.com/channel/ChannellD"
If you input more than 0 characters your YouTube may not display properly

If you input more than 0 characters your About the organization may not display properly

If you input more than 0 characters your Mission and Vision may not display properly
Commitments/Signatures

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Core Principles​, Code of Conduct​, and Accountability Standards​


I confirm that, as the head of the organization, I have carefully reviewed the revised Core Principles, Code of Conduct, and Accountability Standards of MenEngage Alliance. I confirm that our organization and its individual agree with the contents of these documents and commit to upholding, promoting and learning about the values, principles, and commitments contained within them.

Core Principles​


 As the head of the organization, I agree that our organization and its individuals will uphold and promote the Core Principles of MenEngage Alliance. By signing below, I further affirm that we are not in violation of any Core Principles provisions, and have disclosed and will disclose any known violations or potential violations in writing and am otherwise unaware of any further concerns. (Please visit www.menengage.org/abour/reporting-a-concernɳɳ​ for information on the various options for reporting).

If you input more than 0 characters your Core principles may not display properly

Code of Conduct​


As the head of the organization, I agree that our organization and its individuals will uphold and promote the Code of Conduct of CariMAN and MenEngage Alliance. By signing below, I further affirm that we are not in violation of any Code of Conduct provisions, and have disclosed and will disclose any known violations or potential violations in writing and am otherwise unaware of any further concerns. (Please visit www.menengage.org/abour/reporting-a-concernɳ​ for information on the various options for reporting).

If you input more than 0 characters your Code of Conduct may not display properly

Consent

This checkbox is mandatory
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