This website uses cookies to help us give you the best browsing experience. By continuing to use this portal, you agree to our use of this tool.
To learn more about how we use cookies and how to manage them please read our notice here.
Application for membership
Please use this form to request membership to the European Glaucoma Society (fields marked with * are mandatory).

You will need to provide a headshot photograph (max. 1 MB, jpg format) and the details of a sponsor (a member of the EGS, president of your national glaucoma or ophthalmology society, or your head of department) who has agreed to validate your application.

Need help?

Apply for:

  • Ordinary Member
  • Extraordinary Member
  • Member-in-training (will automatically move to ordinary member once proof of residency completion has been sent to egssecretary@oic.it)


Title:
Surname: *
First name: *
Date of birth: * dd -   * mm -   * yyyy
Gender: M     F
Affiliation: *
Work address: *
Town: *
Postal code: *
Country: *
Your photo:
(max 1Mb - jpg format)		 *

Contact telephone number
 
Work: *
Home:
Mobile:
Fax:

E-mail address:
*
Secondary e-mail address:

Glaucoma subspeciality interest
Please select (all that apply):














Residency
 
Start year:
*
End year:
*
Institution(s):
*
City:
*
Country:
*

Start year:
End year:
Institution(s):
  
City:
  
Country:


Clinical Fellowship (if undertaken)
 
Subspecialty:
Start year:
End year:
Institution(s):
City:
Country:

Subspecialty:
Start year:
End year:
Institution(s):
City:
Country:


Research Fellowship (if undertaken)
 
Subspecialty:
Start year:
End year:
Institution(s):
City:
Country:


Current position
 
Start year:
Institution(s):
City:
Country:


Sponsor - The sponsor must be a current member of the EGS, the President of a National Glaucoma or Ophthalmological Society, or your Head of Department. Please ensure that you have asked your sponsor's permission before submitting the form.
 
Surname: *
First name: *
Role: *
E-mail: *


Additional notes:

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


PLEASE DOUBLE CHECK ALL THE ABOVE AND

  Need help?


Process

  • The application process can take place at any time, with proposals being considered at the next Executive Committee Meeting. Meetings are held every month.



back to top
X