EFOMP IAM::EFOMP Individual Associate Membership (IAM)

EFOMP Individual Associate Membership (IAM) Registration Form

Please fill the following electronic form for applying for IAM of EFOMP.

e-Mail *

Password *

Re-type Password *

Name *

Surname *

Date of Birth *

Address *

ZIP code *

City or Province *

Country *

Phone *

Field of Interest *

Profession *

Employing Organisation/Company

The annual fee for EFOMP Individual Associate Membership (EFOMP IAM) for the year 2020 is 15.00 €

You can pay this using your credit card in the next step.

Declaration by Applicant

I wish to apply for EFOMP Individual Associate Membership. I declare that all information provided in support of my application is correct.

I have read and understand and I agree with EFOMP's Privacy Policy on the utilisation of my personal data.

Notice: The Individual Associate Membership is meant for individuals interested in medical physics. Please be aware that no invoices can be issued and no alternative payment method will be accepted for this kind of membership.

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