Online membership application - stage 1 of 3

This form should NOT be used for membership renewals. Please use this form for online application and payment for Ordinary membership ONLY. If you are already an ESE member and you would like to renew your membership please follow our online renewal procedures.

If you do not wish to pay online, please use the printable application form (pdf) (91kb).  Please note, unless ALL sections of the application form are completed, your application will not be processed.

All fields marked with an asterisk(*) are mandatory.

Title *
First Name *  
Last Name*  
Address - Please select
Address *  
Country
Telephone *  
Fax
Email *
Please enter your email again *  
Date of birth * (dd/mm/yyyy)    
Professional Degree
e.g. MD, PhD.

Essential Supporting Information

Applications for Ordinary Membership must be from members of a national medical/scientific society in endocrinology or a related subject.

If you are NOT a member of a relevant organization then please send a letter of recommendation from a senior physician stating that you have an active interest in endocrinology.

Please select the relevant tick box below.

I am not a member of a relevant organization and wish to submit a letter of recommendation.  Your letter should be from a senior physician who, if possible, should be a member of a national medical/scientific society in endocrinology or a related subject.  The society of which they are a member must be written in the letter of recommendation.

Please note, your application will not be processed until this letter is received by the ESE Secretariat.  The letter can sent to info@euro-endo.org, or by fax to +44 (0) 1454 642 222, or by post to ESE Secretariat, Euro House, 22 Apex Court, Woodlands, Bradley Stoke, Bristol. BS32 4JT. UK.

I am a member of a national medical/scientific society in endocrinology or a related subject.  Please write the name of this society in the box below:


 

About your interests
Which one of the following best describes your primary professional role? (please tick only one)



Which of the following describe your area(s) of interest? (you can tick more than one)






My area of interest is primarily (please tick only one)
Payment Information
Member fees

Ordinary Member - Full rate €50 for the 2007 membership year (January to December).

Ordinary Member - Reduced rate €25 for the 2007 membership year (January to December).
I am under 35 years of age
I am retired
My country of residence is not specified as high income by The World Bank.
Journal subscription fees


Reduced subscription rates are available to all ESE members for the ESE official journals. The Journal fees below are for 2008 subscriptions.

European Journal of Endocrinology
€64 Print only
Journal of Endocrinology €145 Print only
Journal of Molecular Endocrinology €95 Print only
Endocrine-Related Cancer €95 Print & on-line

Total Cost €

I have read and understand the terms and conditions (opens in a new window) for application to ESE.
I do not wish to be included in the online membership directory (opens in a new window).

By being a member of ESE, you agree to receive information from ESE on its own and related activities. Occasionally we may organise additional mailings and email alerts on behalf of other organizations with information of interest to ESE members. Please indicate if you do NOT wish to receive such mailings.