Transfert d'Urgence de L'Industrie PharmaceutiquE

Form

Become a partner

To become a Tulipe partner, NGOs and humanitarian associations must meet at least the following conditions:

  • Be an organisation with an initial medical focus
  • Be in existence for at least 3 years
  • Have a pharmacist or doctor registered with their French professional association on the Board of Directors

If you meet these prerequisites, you can send us your donation request by filling in the form below and uploading the requested documents.

Registration

* Champs obligatoires

Contact (name & contact details)

Identité*
Last name
First name
Address
City
Postal code
Phone

Documents to be provided

Accepted file types: pdf, jpg, xls, Max. file size: 2 MB.
Upload a copy of the organisation’s articles of association
Accepted file types: pdf, jpg, xls, Max. file size: 2 MB.
Upload a copy of the doctor’s or pharmacist’s professional card
Accepted file types: pdf, jpg, xls, Max. file size: 2 MB.
Upload a recent mission report
Accepted file types: pdf, jpg, xls, Max. file size: 2 MB.
Upload an initial assessment of monthly drug requirements
Mandatory documents to be uploaded in pdf, jpg or xls format.
GDPR*

* Mandatory fields

This field is for validation purposes and should be left unchanged.