Remit of Antibiotic Action Champions
The aim of Antibiotic Action is to increase awareness in members of the general public,
politicians, policymakers, health care professionals, academic researchers and those in
the pharmaceutical industry of the lack of antibiotic drug discovery, research and
development so as to stimulate this area to produce new antibiotics.
To help deliver the aims of Antibiotic Action, Champions are asked to promote
Antibiotic Action and help increase numbers of signatures on the petition by:


Engaging with peer groups to raise awareness e.g. by giving lectures, putting up
posters, engaging with the media.
Using social media (AA Champion FaceBook page, Twitter) to inform others of
your activities.
Appointment is for two years in the first instance and can be renewed by request or
invitation.
1
ANTIBIOTIC ACTION CHAMPION ACCEPTANCE FORM
__________________________________________________
Name
_________________________
Title
__________________________________________________
Job Title
__________________________________
Street address
___________________
City
____________ _____
Country
Post
Code
__________________________ _____________________ ___________________________
Primary phone number
Other phone number E-mail address
Do you work for a Pharmaceutical Company
☐
Yes, please see next page
☐
No
What activities will you carry out as an Antibiotic Action Champion?
☐
☐
☐
☐
☐
☐
Engage with peer groups to raise awareness.
Lectures using provided PowerPoint presentations to raise awareness within peer groups.
As a way of raising awareness, add 1-2 Antibiotic Action slides to the end of any lectures
given.
Distribution of materials such as posters to raise awareness.
Use of social media e.g. Twitter to raise awareness within peer groups.
Unite and work with other Champions and use AA Champion FaceBook page.
2
If you work for a Pharmaceutical company please complete below:
AA is an independent UK-led initiative and neither its name, brand or activities can be
used to promote any commercial event or activity. Please sign below to confirm your
understanding and acceptance of this statement in acknowledgement that as an AA
Champion you are acting in a personal capacity.
Signature __________________________________________
Information for Website
We would like to put your name, title, photograph and location on the Antibiotic
website. Please tick here if you do NOT wish your name to be included. ☐
Please provide a 100-150 words about yourself and, if you wish, attach a photograph
for the website. We want our readers to know who are Champions are!
Signature __________________________________________
Date ____________________
Please return this form by FAX or as a PDF/scanned attachment to
f.johnson@bham.ac.uk
3
From time to time we would like to email you with information about Antibiotic Action or
other BSAC activities which we believe will be of interest to you. This will not involve
your details being passed to any third party and you can unsubscribe at any time. If
you would like to receive this information please tick the box below.
☐
4