Membership Registration

I wish to become a member and as such have access to all events and website opportunities

Gender

Year of Birth

Title
First Name
Name
Clinic / Institution

Professional Background
Database/IT
Gastroenterology
Genetic Counselling
Medical Genetics
Medical Oncology
Molecular Genetics
Molecular Oncology
Nursing
Pathology
Registry coordination
Research
Surgery
Other:

BUSINESS ADDRESS

Street / P.O. Box

ZIP-Code

City

E-Mail

Repeat E-Mail

Country

Use for Communication
Use for Invoice

PRIVATE ADDRESS

Street / P.P. Box

ZIP-Code

City

E-Mail

Repeat E-Mail

Country

Use for Communication
Use for Invoice

MEMBERSHIP

Membership Fees

(please select your category)

	Clinicians inc. genetic Counsellors, tenured Scientists and Academics	100€
	Students & Junior / non-tenured Academics	50€
	All Others (eg retired: contact us with your personal status)	50€
	Patients / lay Members	25€
	Industry Membership (Please visit Sponsorship)	500€

VAT Number

PO Number

(if applicable)

Membership application deadline (2022 – 2023) for participation in the virtual meeting: Sept 15, 2022.
Unrestricted membership application anytime for 2022 – 2023, financial year closes June 30, 2023.

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