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.

Please bare in mind that New Membership Applications will only be considered for applicants (ophthalmologists) with a special interest in Glaucoma practising within the geographical boundaries of Europe.

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.

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] Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Italy Latvia Liechtenstein Lithuania Luxembourg Macedonia Malta Moldova Monaco Montenegro Netherlands Norway Poland Portugal Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Turkey Ukraine United Kingdom
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 4Mb)	*
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