Partners Account Request Form

 


With Partners, all of your California Tobacco Control Information needs are at your fingertips!

  • Partners Updates are sent weekly to its members, informing them of the latest administrative, legislative, evaluation, and media campaign news, as well as upcoming events, informational tools, and much more!
  • You will also find the Capacity Building Network's (CBN) Subsite within Partners, featuring their exclusive CTCPeers technical assistance service.
  • Another new addition is InfoHub, a robust, user-friendly online forum with customizable threads where you can chat with your colleagues on a variety of topics.
  • Partners provides comprehensive web links to other local, regional, and statewide CTCP-funded websites, including a link to Rover and OTIS.
Only staff from projects funded by the California Department of Public Health (CDPH),
California Tobacco Control Program (CTCP), and related subcontractors are eligible to apply for Partners membership.

Click here for OTIS/Rover account information

Please have the person applying for a Partners membership fill out the form below,
acknowledge the membership Terms and Conditions, and click on the "Submit" Button.
The person applying for the membership must fill out the form themselves.


Your First Name *
Your Last Name *
Your Position Title *
Your Email Address  (Your Login Info will be sent here)
Phone # * (xxx-xxx-xxxx)
Official Agency Name *
Project Director's Name *
Project Director's Email *
Address *
City *
State *
Zip Code *
Official Project Name *
CTCP Consultant (PC) *   (If "Not Applicable" is selected, please explain below)
Additional Instructions or Comments
* Fields marked in yellow are required.


I have read and agree to the Terms and Conditions above