Dedicated to reducing disability and death from cardiovascular diseases and stroke in the Americas 08th of September 2010
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Membership registration («« = minimum information)

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Type of membership:   ««
Name of organization:   ««
Name of president:  
President's e-mail:  
Name of contact:  
 
(if different from President)  
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Contact e-mail:   ««
Please attach list of Board  members and principal staff:  
Address:  
City:  
State:  
Postal Code:  
Country:  
Phone:  
(include city and country code)  

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Fax:  

Purpose of your organization:

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Organizational Information:

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Background:

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Aims and Objectives:

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Organizational Structure:

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Projects:

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Tobacco Control Activities:

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Please disclose any actual or potential conflicts of interest:

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Please, answer the next question: ««

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How much is 4 + 6?

 
This question helps us differentiate a person from a computer that autofills forms to generate SPAM.
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Yes, I have read the InterAmerican Heart Foundation By-Laws and its membership fee structure and agree to abide by them. ««
  
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