Request AMICAL Friend or Partner status

Request AMICAL Friend or Partner status
That you for your interesting in becoming an AMICAL Friend or Partner. Make sure to read the “Friends & Partners Program” web page, if you haven’t already, as it provides important details about this program, including the benefits and expectations.
Name*

First NameLast Name
Email*
Current institution*
Current job title*
Past relationship with AMICAL (tick all that apply)*

I used to work at an AMICAL member institutionI was a major contributor to an AMICAL program, event, or project
- AMICAL institution where you worked*
- Job title at the AMICAL institution where you worked*
- Describe your past partnerships with AMICAL members*
- I am applying for the following status:*
  
  Friend – stay in touch with the ConsortiumPartner – participate actively in the Consortium
- Describe your interest in AMICAL's mission, including any anticipated future partnerships with AMICAL members*
- Name of AMICAL colleague or group who is endorsing your application*
- I confirm that I am NOT currently working for a commercial entity or an organization with a business relationship to AMICAL or its member institutions.*
  
  Yes
- I agree to the “Engagement expectations” described in the “Friends & Partners Program” page linked above*
  
  Yes
- After submitting the form you will be taken to a “Thank you!” page, indicating that the submission was successful. If you do not reach this page, then something has gone wrong. Consult our form troubleshooting page to find out how to proceed.
- Should be Empty: