EUROPEAN SOCIETY OF NEURORADIOLOGY - Diagnostic and Interventional

Membership > Application Form

Application procedure:

Please complete all the required fields marked with *
Upload a short CV including your present and previous places of practice
Submit (by clicking below) the completed application form to the Membership Committee
The Membership Committee will review your application, assign appropriate membership category and give recommendations to the General Assembly of the Society that has the power to admit new members at the annual meeting of the ESNR. The Junior Members will receive temporary acceptance by the Membership Committee to be confirmed during the next coming General Assembly
Once approved as new member of the Society, you will be asked to pay the appropriate membership fee
If your institution is not listed, please e-mail info@esnr.org with the details.

Gender *Male Female

Date of Birth * e.g. 19 Jan 1970

Title *

First name *

Last name *

Speciality *

Institution

Department

Street and number *

City *

Postcode *

Country *

Please tick here if the above is your home address

E-mail *

Telephone *

Fax

Upload your CV * File types: doc, pdf, rtf, txt

Please reply to all questions below in order for the Society to know the composition of the membership and to assign you the correct membership category!

Membership Type *

Are you in training to become a neuroradiologist?

Have you done a fellowship or equivalent in neuroradiology?

If so, how long? months, where

How much of your every day practice is devoted to neuroradiology? * < 50% > 50%

If your practice is > 50%, how long have you been practicing neuroradiology years

Your work is conducted in/nature of practice: *

University hospital Private practice Community hospital Company representative Scientist / physicist
Other

Academic position and degree *

Your country of practice *

SUBMIT