ASHM Partnership Program Expression of Interest Applicant Person making application E-mail Phone Working Title What do you want to do – outline of proposal Event type Target audience Purpose Why do you want to partner with ASHM What inputs do you want from ASHM Which of ASHM Objects would this partnership support Is this an educational event If this is an educational event, how will independence of the faculty be maintained How will the faculty conduct its business How would you propose to support the independent ABN 48 264 545 457 Level 7, 46-56 Kippax Street, Surry Hills NSW 2010 Locked Mail Bag 5057 Darlinghurst NSW 1300 Telephone +61 2 8204 0700 Fax +61 2 9212 2382 Email ashm@ashm.org.au Web www.ashm.org.au faculty How frequently would the faculty meet (this may be suggested by applicant and set by ASHM or the faculty) Nominated decision maker from the applicant entity Details if deferent from the applicant Contact details What is your budget, if set please provide details Please attached your prospectus against which you require ASHM to bid/estimate Form of recognition sought If event Date Location Evaluation Assessment ASHM Initial Assessment Feedback Date Completed by Response Contact Follow-up The initial EOI should be no longer than 5 pages. A separate prospectus and or proposed contract may be attached. Please send the EOI to app@ashm.org.au. 2 5.1 Objects 2. (from the ASHM Constitution) The Company is a charitable institution and a health promotion charity. The Objects of the Company are: a. to provide support and representation to health care providers in the areas of HIV, viral hepatitis and sexually transmitted infections; b. to reduce the impact of HIV, viral hepatitis and sexually transmitted infections by supporting, promoting and facilitating workforce development to ensure the delivery of optimal care; c. to foster education for health professionals and the general public through the provision of higher and vocational education courses (and any other continuing education courses) which encourage free intellectual inquiry; d. to facilitate, foster and advance scientific practice and research; e. to facilitate liaison between and across disciplines to support a partnership approach to dealing with, managing and preventing these conditions, particularly, but not limited to: a. clinical and laboratory practitioners; b. specialist and generalist care providers; c. service providers and policy makers; and d. promoting multidisciplinary approaches; f. to promote informed public discussion of issues related to HIV and viral hepatitis, sexually transmitted infections and related conditions; g. to liaise with other national or international bodies whose objects are similar to those of the Company; h. to assist those involved in health care provision in developing countries to achieve these objects and, in particular, to undertake development and/or aid activities in relation to those objectives in those countries; i. to attempt to meet any other needs of the Members and the members of the community, through the provision of education, training and support and from participating in the sector j. to operate an overseas aid fund (called the “ASHM International Aid Fund”); and k. anything ancillary to the Objects set out in clauses 5.1(a) – (k). 3 Standard Acknowledgements Program Logo 3. This activity is conducted under the ASHM Partnership Program. Partners to this activity are ASHM and <XYX> ASHM logo to be developed Globe + ASHM Partnership Program Partner logos ASHM and partner logos should be applied using the relevant organisations style guide and in compliance with any additional badging requirements and agreed by both parties Standard 1. Participation in this APP activity does not convey Acknowledgements endorsement of any partners goods, service, products or opinions 2. The opinions expressed in this material are the opinions of the presenter and are not endorsed by ASHM or <XYZ> 3. The content in this material was developed by an independent faculty and does not reflect the opinions of ASHM or <XYZ> 4. The content in this material was developed by an independent faculty appointed by ASHM and given explicit authority to act on behalf of ASHM and as such are endorsed by ASHM. 5. The material was developed as part of an unconditional grant for educational purposes and has been developed in accordance with ASHM policies and procedures and as such reflects the views and opinions of ASHM 6. The material was developed using funds donated to the ASHM Gift Fund. ASHM would like to thank <XYZ> for this most appreciated gift. Donations to the fund are tax deductible and can be made at <www.ashm.org.au/gift > The Panel will determine the appropriate acknowledgement and may develop further wording from time-to-time and may withdraw wording options. 4