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Member Registration

Section A: Personal details (All applicants to complete)

Surname: *

Given name: *

Log-in name: *

Password (up to 8 characters): *

Confirm password: *

Email address: *

Nationality: *

Country of residence: *

Are you an occupational therapist?
Yes No

If yes, year of graduation:

Institution:

Country:

Are you an occupational therapy student?
Yes No

If yes, institution:

Country:

Are you a member of an occupational therapy professional association?
Yes No

If yes, which one?

Are you an individual member of WFOT?
Yes No

Section B: Interest/experience working in developing countries or with other under-resourced client groups (All applicants to complete)

Are you currently working as an occupational therapist in a developing country? (If yes, also complete Section C)
Yes No

Have you previously worked as an occupational therapist in a developing country? (If yes, also complete Section D)
Yes No

Are you interested in working as an occupational therapist in a developing country in the future?
Yes No

Are you interested in supporting the work of other occupational therapists in developing countries?
Yes No

Are you undertaking, or have you completed, any academic study in the area of development?
Yes No

If yes, course name:

Institution:

Country:

Have you undertaken any research or projects relating to occupational therapy in developing countries (including student projects)?
Yes No

If yes, details (title and key words only):

Have you published any journal articles relating to occupational therapy in developing countries?
Yes No

If yes, details (title and key words only):

Have you developed any resources for use by occupational therapists in developing countries?
Yes No

If yes, details (title and key words only):

Have you presented any conference papers or workshops relating to occupational therapy in developing countries?
Yes No

If yes, details (title and key words only):

With respect to working in developing countries, or with other under-resourced client groups, indicate which of the following categories you have significant experience or strong interest in (you can register more than one group):
Amputees
Burns
Community Based Rehabilitation
Consultation
Disability awareness
Education and training (non health professionals)
Environmental access
Equipment provision
Hand therapy
HIV/ Aids
Home modifications
Indigenous communities
Intellectual disability
Leprosy
Mental Health
Migrants
Neurology
Occupational Therapy education and training
Occupational Therapy student supervision
Orthopaedics
Paediatrics
Physical disability
Polio
Prisoners
Project Management
Refugees
Research
Rural and remote
Spinal cord injury
Street children
Vocational Rehabilitation
Other:

Section C: Occupational Therapists/students currently working in developing countries to complete

Country:

Name of employer/host organisation:

Name of sponsoring organisation (if applicable):

Type of work undertaken e.g. clinical, teaching/training, academic/research, project management, consultation:

Please write a brief description about your current work to share with other OTION members (maximum 150 words):

Section D: Occupational Therapists/students with previous experience working in developing countries to complete

Country:

Name of employer/host organisation:

Name of sponsoring organisation (if applicable):

Type of work undertaken e.g. clinical, teaching/training, academic/research, project management, consultation:

Please write a brief description about your experience to share with other OTION members (maximum 150 words):

Have you had previous experience working in other developing countries?
Yes No

Country:

Name of employer/host organisation:

Name of sponsoring organisation (if applicable):

Type of work undertaken e.g. clinical, teaching/training, academic/research, project management, consultation:

Please write a brief description about your experience to share with other OTION members (maximum 150 words):