Membership application form Membership application I wish to apply for Ordinary membership - current VascAgeNet memberOrdinary membershipStudent membership If applying for Student Membership, please read and tick below. If you are not applying for Student Membership, please tick 'I am not applying for Student Membership' Student Membership is open to PhD students/trainees working in the field of cardiovascular (patho)physiology who have not yet published sufficiently to qualify for Ordinary Membership. The maximum term for Student Membership of the Society shall be 5 years. Student Membership shall not apply to those studying for a second degree. Once students have completed their PhD and have an adequate number of publications, they will be required to re-apply for Ordinary Membership. Please tick below to state that you are still eligible for Student Membership, you will also need to upload a certificate/document confirming this, in the upload section below. * I confirm that I am within 2 years of my PhD and that I am eligible for Student Membership I am NOT applying for Student Membership If applying for a student membership please advise the date - or prospective date - of PhD award. If applying for Ordinary membership as VascAgenet member, please confirm VascAgeNet member If you would like to join the ARTERY Young Investigator Network, please confirm that you are under 40. I am under 40 years old. Title * ProfessorAssociate ProfessorDrMrMrsMissOther Title Forename * Surname * Gender Male Female Job Title Clinician/Non-Clinician Clinician Non-Clnician Academic Qualifications * Organisation * Address 1 * Address 2 Address 3 Address 4 City Postcode Country * Phone Number Email Address * I consent to ARTERY Society storing my data for Society related matters * Yes No I confirm that I am happy to newsletters and emails from ARTERY Society * Yes No Please give the name of one ARTERY member supporting your application - VascAgeNet applicants please reference Christopher Mayer * Please give the name of one ARTERY member supporting your application - VascAgeNet applicants please reference Christopher Mayer First First Last Last Please upload two statements of support from ARTERY members - this is not required for VascAgeNet members. Drop a file here or click to upload Choose File Maximum file size: 52.43MB Please upload a copy of your CV * Drop a file here or click to upload Choose File Maximum file size: 52.43MB Please upload a list of your publications * Drop a file here or click to upload Choose File Maximum file size: 52.43MB Student Membership - please upload supporting document in this section Drop a file here or click to upload Choose File Maximum file size: 52.43MB Radio Buttons Option 1 Option 2 If you are human, leave this field blank.
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