Rainbow Across Borders |Rainbow Across Borders

JOIN THE RAB NETWORK

Rainbow Across Borders (RAB) aims to improve the quality of life of, and give dignity to, patients and their families challenged by chronic or life-threatening illnesses.
RAB is Asia′s first regional patient support group alliance which promotes regional collaboration and networking among patient support organisations from countries within the Asia-Pacific region. RAB aims to empower patient support organisations through appropriate programmes, services and training, while facilitating learning and experience exchange among the RAB affiliates in our network.

Please fill in this form to register your organisation's interest in becoming an affiliate of Rainbow Across Borders.

*Name of Organisation:

*Country:

Society/Organisation/Charity Registration Number:

*Year of registration/formation:

Document Upload: Copy of Registration Details (Formats: Word, PDF, Jpeg)

*Please specify the patient illness group(s) which your organisation supports:

Organisation's Logo Upload (Formats: Jpeg, Png, PDF)

Website URL:

Please indicate your association and/or affiliation with other entities: (You may select more than one.)

Hospital

Patient support organisation

Member/affiliate of an alliance or organisation

Contact Information

*Contact Person's Name:

*Designation:

*Organisation:

*Email:

Phone Number:

Mobile Number:

*Postal Address:

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