GAMIAN Europe Full Membership Application Form
GAMIAN Europe Full Membership Application Form With the present, EUTIMIA—Aliança Europeia Contra a Depressão em Portugal (EAAD.PT), through its branch of action, and brand, Superviver-e, devoted to suicide survivor’s users, declares its willingness to become an associate member of GAMIAN-Europe, in the respects of its constitution and objectives. Signature Please send the filled and signed form by: email to: info@gamian.eu post to: GAMIAN-Europe Washington street 40, 1050 Brussels, Belgium Tel: +32 494 52.79.80 Fax: +32 9 270.32.70 GAMIAN Europe Full Membership Application Form Please correct, complete or update the following information Name of organization in original language SUPERVIVER-E ramo operacional de: EUTIMIA—ALIANÇA EUROPEIA CONTRA A DEPRESSÃO EM PORTUGAL (EAAD.PT) Name of Organization in English SUPERVIVER-E operational branch of: EUTHYMIA—EUROPEAN ALLIANCE AGAINST DEPRESSION IN PORTUGAL (EAAD.PT) Short name/acronym Signature SUPERVIVER-E EUTIMIA—ALIANÇA EUROPEIA CONTRA A DEPRESSÃO EM PORTUGAL (EAAD.PT) Country Portugal Zip Code 1050-099 City Lisboa Address Av. Elias Garcia 147, 2º Dtº Telephone 00 351 217 828 76 17 Fax Website www.eutimia.pt (under construction) e-mail eutimia.info@gmail.com President /Chair Ricardo Gusmão e-mail rgusmao@mac.com Please send the filled and signed form by: email to: info@gamian.eu post to: GAMIAN-Europe Washington street 40, 1050 Brussels, Belgium Tel: +32 494 52.79.80 Fax: +32 9 270.32.70 GAMIAN Europe Full Membership Application Form Contact person Vânia Cerqueira e-mail vaniacerqueira@gmail.com Number of members 30 Number of members in the Board 5 Number of patients in the Board 3 Patient participation in the decision making process (Yes/No) Yes Activities realizing patient participation (Yes/No) Yes Mission/Objectives: English translation/summary of the aims of the organisation as mentioned in the statutes (max 250 words) EUTIMIA – Aliança Europeia Contra a Depressão em Portugal (EAAD) has the mission to develop strategies for integrated, multidimensional prevention of depression and suicidal behavior, seeking greater mental wellbeing of the population and the reduction of mortality from suicide, through the translation of knowledge and attitudes, on multiple levels, and the creation of social and interinstitutional networks with synergistic effects. As such, EUTIMIA has the purpose: to contribute and promote to the realization of the dignity of all through respect, effective implementation and guarantee of human rights, as defined in the Universal Declaration of Human Rights; to promote and serve the public and social interest of the people in the fight against depression and suicide in Portugal and abroad, notably in portuguese-speaking countries and promote social accountability of operators and socio-economic actors. An invoice for the yearly membership fee (125 €/150 € membership by the membership committee. 1 125 € if paid before April 1st, 150 € if paid after April 1st. Please send the filled and signed form by: email to: info@gamian.eu post to: GAMIAN-Europe Washington street 40, 1050 Brussels, Belgium Tel: +32 494 52.79.80 Fax: +32 9 270.32.70 (1) in 2012) will be send after acceptance of your GAMIAN Europe Full Membership Application Form All organisations or persons, being personally or professionally involved in the field of Mental Health can become member of GAMIAN-Europe. To encourage and promote information, education and awareness on current knowledge of the treatment and support available to those affected by mental illness having regard to the latest evidence based material. To support and engage in research projects pertaining to mental illness and the dissemination of the results of such research. To offer assistance to member organisations when required and develop support and training mechanisms for their members. Regarding decision makers it is extremely important to fall back on a real societal support. The same goes for fundraising. Criteria for full membership are defined in Article 6 of the statutes(2): Any non-profit body or non-profit organization, concerned with or engaged in support of patients with mental illness and those who care for them, having patient representation on its board and having activities realizing patient participation shall be eligible for full membership provided they are resident or based in Europe.(WHO definition) Advantages of full membership: information on all GAMIAN-Europe activities, Flash news (10 x year); voting right on the general assembly; invitation for the annual convention (free accommodation -3 nights- and reimbursement of travel expenses up to 400 €); possibility to participate at Regional Seminars for the full members of the concerned region; ative Involvement in GAMIAN-Europe projects (Stigma survey, Physical and Mental Health Survey, etc…); participation (eligibility) at GAMIAN-Europe Good Practices Award. (2) Full statutes of GAMIAN-Europe can be consulted in www.gamian.eu. Please send the filled and signed form by: email to: info@gamian.eu post to: GAMIAN-Europe Washington street 40, 1050 Brussels, Belgium Tel: +32 494 52.79.80 Fax: +32 9 270.32.70
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