ESNAM: The Application for membership

 

I / We would like to become a member of the Europan Society for nanomedicine as
 Individual Member
 Corporate Member
(Legal, industrial, charitable, or governmental legal entities)
 Student Member

 

Title:

First name:*

Last name:*

Profession:

Company / University:

Department / Affiliation:

Address:*

ZIP code:*

Town:*

Country:*

Phone:*

Fax:

E-Mail:*

 

I work clinically.
yes no

I am involved in nanomedical applications as a scientist / researcher.
yes no

 

(The following question relates to ESNAM's aim to guarantee a high level of transparency regarding its industry relations)
I am directly or indirectly associated with a company or institution with a commercial interest in nanomedicine.
yes no

 

I am / we are interested in:

Receiving the European Journal for Clinical Nanomedicine (academic journal)

Information about the scientific conferences and activities of the network

News on nanomedical therapies and diagnostic tools

Ethical and philosophical debates on nanomedicine

Specifically:

I am / we are active in the following field:*

Please upload the file containing your CV:*

 

In case that you are handling the application for someone else, please tell us your name, address, and E-mail contact.

 

Name of sender:

Address:

ZIP code:

Town:

Country:

E-Mail:

Phone:
   

 

  I agree that these data are used according to the legal regulations, including maintenance of the membership list and for information transfer between the European Society for Nanomedicine, the European Foundation for Clinical Nanomedicine and the members.

 

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