{"id":7945,"date":"2024-12-15T18:38:25","date_gmt":"2024-12-15T18:38:25","guid":{"rendered":"https:\/?page_id=7945"},"modified":"2025-06-03T18:47:49","modified_gmt":"2025-06-03T18:47:49","slug":"membershipf","status":"publish","type":"page","link":"https:\/\/eutranslationalmedicine.org\/aii\/membershipf\/","title":{"rendered":"Alliance Membership Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7945\" class=\"elementor elementor-7945\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-261b3d5 e-flex e-con-boxed e-con e-parent\" data-id=\"261b3d5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f74260c elementor-widget elementor-widget-image\" data-id=\"f74260c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1920\" height=\"884\" src=\"https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-scaled.webp\" class=\"attachment-full size-full wp-image-7935\" alt=\"\" srcset=\"https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-scaled.webp 1920w, https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-300x138.jpg 300w, https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-1024x472.jpg 1024w, https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-768x354.jpg 768w, https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-1536x708.jpg 1536w, https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-2048x943.jpg 2048w, https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-1568x722.jpg 1568w, https:\/\/eutranslationalmedicine.org\/aii\/wp-content\/uploads\/2024\/12\/business-girl-showing-membership-word-wooden-block-600x276.jpg 600w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-108e718 e-flex e-con-boxed e-con e-parent\" data-id=\"108e718\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0392601 elementor-widget elementor-widget-heading\" data-id=\"0392601\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Alliance Membership FOrm<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a90b34 elementor-widget elementor-widget-text-editor\" data-id=\"5a90b34\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Welcome to the <em>Alliance for Immunology Innovations&#8217;<\/em> application form. Please provide the following information to apply for membership. This form is intended for researchers and innovators in the field of immunology interested in collaboration, commercialization, and advancing immunological research. Please also download the below membership agreement document and upload the signed version in the membership form.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-852f9f0 e-flex e-con-boxed e-con e-parent\" data-id=\"852f9f0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-36f1308 elementor-widget elementor-widget-heading\" data-id=\"36f1308\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Alliance for Immunology Innovations (AII) Membership Form\n<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f50d0d4 elementor-widget elementor-widget-shortcode\" data-id=\"f50d0d4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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                        <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/aii\/wp-json\/wp\/v2\/pages\/7945' data-formid='1' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_1' class='gform_fields left_label form_sublabel_below description_below validation_above'><fieldset id=\"field_1_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_hidden_label gfield--has-description field_description_below field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row' id='input_1_5'>\n                            \n                            <span id='input_1_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_1_5_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_5_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Family Name *<\/label>\n                                                <\/span>\n                            \n                            \n                            \n                        <\/div><div class='gfield_description' id='gfield_description_1_5'>Enter your full name as you would like it to appear on Alliance materials.<\/div><\/fieldset><div id=\"field_1_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_34'>Job Title\/Position<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_1_34' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_34\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_1_34'>Enter your current title or role (e.g., Principal Investigator, Research Scientist, CEO).<\/div><\/div><div id=\"field_1_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_35'>Institution\/Organization<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_1_35' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_35\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_1_35'>State the name of your affiliated institution or organization.<\/div><\/div><div id=\"field_1_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_36'>Institution\/Organization Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_1_36' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='University' >University<\/option><option value='Research Institute' >Research Institute<\/option><option value='Hospital\/Healthcare' >Hospital\/Healthcare<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_1_49\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_49'>Email Address*<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_49' id='input_1_49' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_1_49\" \/>\n                        <\/div><div class='gfield_description' id='gfield_description_1_49'>Enter the best email address for Alliance-related communications.<\/div><\/div><div id=\"field_1_11\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_11'>City &amp; Country*<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_1_11' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_37'>Website or LinkedIn Profile (Optional)<\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_1_37' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_37\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_1_37'>Link to a professional profile or institutional page.<\/div><\/div><div id=\"field_1_38\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_38'>Primary Field of Expertise<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_1_38' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Immuno-oncology' >Immuno-oncology<\/option><option value='Autoimmune Diseases' >Autoimmune Diseases<\/option><option value='Vaccine Development' >Vaccine Development<\/option><option value='Infectious Diseases' >Infectious Diseases<\/option><option value='Diagnostic Immunology' >Diagnostic Immunology<\/option><option value='Transplant Immunology' >Transplant Immunology<\/option><option value='Inflammatory Diseases' >Inflammatory Diseases<\/option><option value='Neuroimmunology' >Neuroimmunology<\/option><option value='Allergy and Immunology' >Allergy and Immunology<\/option><option value='Vaccine Adjuvants and Immunostimulants' >Vaccine Adjuvants and Immunostimulants<\/option><option value='Personalized Immunology and Genomics' >Personalized Immunology and Genomics<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_1_17\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_17'>Research Interests or Specializations (300 words max)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_1_17' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_17\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_1_17'>Briefly describe your main areas of research or innovation and any specific immunological interests. (non-confidential)<\/div><\/div><div id=\"field_1_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_19'>(Optional) Non-Confidential Relevant Patents or IP Summary (If Any) (200 words max)<\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_1_19' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_19\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_1_19'> List any Non-Confidential patents or intellectual property summary you hold or have contributed to.<\/div><\/div><div id=\"field_1_40\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_above gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_40'>Reason for Joining the Consortium<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_40' id='input_1_40' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Networking and Collaboration' >Networking and Collaboration<\/option><option value='Access to Licensing and Commercialization Opportunities' >Access to Licensing and Commercialization Opportunities<\/option><option value='Research Funding' >Research Funding<\/option><option value='Knowledge Sharing and Resources' >Knowledge Sharing and Resources<\/option><option value='Presentation Opportunities' >Presentation Opportunities<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><fieldset id=\"field_1_41\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_above gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Areas of Interest for Collaboration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_1_41'><div class='gchoice gchoice_1_41_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.1' type='checkbox'  value='Networking'  id='choice_1_41_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_41_1' id='label_1_41_1' class='gform-field-label gform-field-label--type-inline'>Networking<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_41_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.2' type='checkbox'  value='Basic Research'  id='choice_1_41_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_41_2' id='label_1_41_2' class='gform-field-label gform-field-label--type-inline'>Basic Research<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_41_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.3' type='checkbox'  value='Clinical Research'  id='choice_1_41_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_41_3' id='label_1_41_3' class='gform-field-label gform-field-label--type-inline'>Clinical Research<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_41_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.4' type='checkbox'  value='Technology Development'  id='choice_1_41_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_41_4' id='label_1_41_4' class='gform-field-label gform-field-label--type-inline'>Technology Development<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_41_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.5' type='checkbox'  value='Clinical Trials'  id='choice_1_41_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_41_5' id='label_1_41_5' class='gform-field-label gform-field-label--type-inline'>Clinical Trials<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_41_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.6' type='checkbox'  value='Funding Opportunities'  id='choice_1_41_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_41_6' id='label_1_41_6' class='gform-field-label gform-field-label--type-inline'>Funding Opportunities<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_1_41_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.7' type='checkbox'  value='IP Licensing &amp; 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