Application form

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First Name
Family Name
Title
Organisation
Street Address
Address (cont.)
City
Zip/Postal Code
Country
Work Phone
E-mail
Speciality: Ophthalmologist:
""Neurologist:

 

Other: Which?

 

If in training, please state the head of the department
I do not wish to expose my name and e-mail address in a secured area on the website
 

Please click here for details on how to transfer the membership fee.

The fee is 100 Euro for full membership. Until 2011 it is free for members-in-training.

Members-in-training are requested to provide a letter from the head of their programme and submit it to the Secretary of EUNOS, Klara Landau, by fax *41-44 255 4349

 

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