MEMBERSHIP APPLICATION / DEMANDE D’ADHÉSIONRegular members – Associate members (including trainees) – Emeritus members
The following online application will be forwarded to the Coordinator of CSATVB Memberships. The credentials of the candidate will then be presented by the Coordinator at the following Executive Business Meeting for review and approval. The list of approved nominations will be presented to the October general annual business meeting for election to the Society. Dues: Regular membership: 25.00$; Associate membership: 25.00$, Associate-trainees: students, residents and postdoctoral fellows: 10.00$ * required fields
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*Type:
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details
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*Title:
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*First Name:
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*Last Name:
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Degrees:
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MSc, Ph.D, MD, FRCP, etc
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*Present Position:
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Trainee Program:
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BSc, MSc, Ph.D., MD, MD/MSc, MD/Ph.D., PostPhD, specify other
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Program Start Date:
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format: mm/dd/yyyy
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Program End Date:
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format: mm/dd/yyyy
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Supervisor Name:
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Supervisor Email:
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*Institution:
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(Hospital, University,or Company)
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Department:
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Building / Room:
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* Address:
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Address2:
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* City:
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* Postal:
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* Province:
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*Country:
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* Phone:
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Fax:
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*Email:
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Attachments :
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click once .. it takes a few seconds
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