New members have to be proposed by two members of the society, one of whom is a member of the Executive Committee. This can take place at any time, with proposals being considered at the next meeting of the Exec. Co. The Executive Committee decides whether the proposed members are acceptable to the society.

The database of members names and addresses is the property of the Society and will be kept by the Secretariat. Members are expected to ensure that an up to date correspondence address is kept with the secretariat. Failure to inform the secretariat of a change of address could lead to loss of membership of the Society.

Any new membership applications shall be supported by two (2) written recommendations: one by a member of the Executive Committee and one by an Ordinary Member of the Society.

Additionally, the applicant is requested to provide a statement from the chairman of an opthalmology department in his/her region (printed on paper with the department's heading and signed by the chairman), which confirms that the candidate is a registered ophthalmologist with an expertise or interest in the field of glaucoma, and that the applicant is a suitable candidate to become a member of the EGS society.

Please use this form to request membership to the European Glaucoma Society (fields marked with * are mandatory):

Title:	Dr. Prof.
Surname:	*
First name:	*
Date of birth:	* dd -   * mm -   * yyyy
Affiliation:	*
Work address:	*
Town:	*
Postal code:	*
Country:	[please select] Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ascension Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswanasd Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Colombia Comoros Congo Congo, Democratic Republic of th Cook Islands Costa Rica Côte D'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europe Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Repub Korea, Republic of Kuwait Kyrgyz Republic Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino São Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Islands Yemen Zambia Zimbabwe
CONTACT TELEPHONE NUMBER
Work:	*
Home:
Mobile:
Fax:
E-mail address:	*
Secondary e-mail address:
TRAINING DETAILS
Resident training (hospital/city/years):	*
Fellowship training (hospital/city/supervisor/ years):
Medical qualifications:	*
GLAUCOMA SUBSPECIALITY INTEREST Please select (min 1 - max 3 interests):
Perimetry Therapeutics medical Therapeutics lasers Therapeutics surgical Research - clinical Research - basic science Imaging Epidemiology Genetics Basic Science Health Economics General Other (specify):
CURRICULUM VITAE
Upload curriculum vitae: (max 1Mb - doc, txt or rtf format)	*
LETTER WITH STATEMENT
Upload letter: (max 1Mb - doc, txt or rtf format)	*
SPONSOR 1 - The first sponsor must be a member of the EGS Executive Committee
Title:	Dr. Prof.
Surname:	*
First name:	*
Position:	*
E-mail:	*
SPONSOR 2 - The second sponsor must be an Ordinary Member of the Society
Title:	Dr. Prof.
Surname:	*
First name:	*
Position:	*
E-mail:	*
Additional notes:

Before submitting this form, please type the four characters displayed above:

PLEASE DOUBLE CHECK ALL THE ABOVE AND