Corresponding Membership Application

Please submit this form together with a full CV and letter of support by an ESPGHAN Full- or Emeritus Member, not currently serving on the Council and in good standing.

Your supporting documents (CV and support letter) will be submitted to members for voting. Please make sure to omit data you do not wish to share with our members.

Title *

Gender

First name *

Surname *

Date Of Birth (dd/mm/yyyy) *

Postal Address *

Post Code *

City *

Country *

Billing address is different from the postal address

email *

telephone

Main focus of professional activity

Name of the ESPGHAN Full- or Emeritus Member (not currently serving on Council and in good standing) supporting my application *

CV *

Select a file

Only Pdf or word file. Please avoid special characters such as ä, æ, ē, õ, é, &, ", (, <, -, ... in the document's title.

Recommandation letter *

Select a file

Recommandation letter from the ESPGHAN Full- or Emeritus Member (not currently serving on Council and in good standing). Only Pdf or word file. Please avoid special characters such as ä, æ, ē, õ, é, &, ", (, <, -, ... in the document's title.

General Terms and Conditions *

I have read and accept the General Terms and Conditions

I accept the use of my data:
– In the legitimate interest of membership benefits (newsletter mailing, Annual Meeting information and registration, voting rights, receipt of JPGN, dissemination of scientific and research related information, Awards and Grants).
– In the planning of educational events and other ESPGHAN related activities.
– To comply with legislation.
For more details, please refer to our privacy policy.