ACEM GECCoP Membership Registration Form

GECCoP Membership Registration Form

Please fill out this form to submit your registration to join.
The Global Emergency Care Community of Practice

The Global Emergency Care Community of Practice (GECCoP), facilitated by the Australasian College for Emergency Medicine (ACEM), aims to bring together like-minded individuals to share ideas, innovations and opportunities in global emergency care (GEC). We envisage this informal community-led forum will facilitate effective communication and partnership between individuals and organisations engaged in GEC capacity development across the Indo-Pacific region.

GECCoP will meet virtually at least twice per year, providing a forum for resource sharing, networking, and mutual learning among the GEC community. To promote multi-disciplinary engagement, GECCoP is co-chaired by a Fellow of ACEM (FACEM) as well as a non-medical GEC practitioner from the GEC community. The current GECCoP co-chairs are Dr Dani Clark (FACEM chair) and Ms Kristalee A Horoto (non-medical chair).

GECCoP membership

There are two categories of membership: individual and organisational. Participation is free of charge. Individual membership is for clinicians and development practitioners with an interest in GEC, while organisational membership is for those stakeholders involved in GEC capacity development.

If you wish to become a member of GECCoP and be contacted about GECCoP activities, please complete and submit the following form.

GECCoP membership

Please indicate what type of membership you want.
Membership*

IndividualOrganisational
Personal information

Please complete all fields.
Name*

TitleFirst NameLast Name
Position*
Organisation*
Email*
example@example.com
Mobile*

Area CodePhone Number
Current emergency care role*

Specialist emergency medicine doctorTrainee emergency medicine doctorOther specialist doctorOther trainee or junior doctorNurseCommunity healthcare worker or nursing assistantClinical officer, clinical assistant or health extension officerParamedic or ambulance officerProgram managerOther
Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
GECCoP membership code of conduct

Please read through the code of conduct.
The GECCoP is a community-led forum. We ask that members:
- treat all persons with respect and courtesy, and with sensitivity to the needs of individuals from diverse backgrounds
- resolve disagreements with colleagues in a constructive manner
- utilise the resources of GECCoP responsibly and appropriately
- that information shared in the forums is not utilised for commercial use or gain.
I agree to these terms and conditions*

Yes
Disclaimer

Photography and/or videography may take place at GECCoP events.
Please indicate your consent for ACEM to use the associated images in internal and external media and communications for promotion of GECCoP.

I consent to this conditionI do not consent to this condition

Thank you!
Thank you for registering to become a member of GECCoP, we look forward to you participating in the GECCoP and its activities. If you have any queries, please email: gecnetwork@acem.org.au.
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GECCoP Membership Registration Form