Application Procedure

Each person applying for Membership should complete the following application form and provide a short CV and a list of recent publications. Alternatively, the signature of an ordinary ESN Member should support the application

EUROPEAN SOCIETY FOR NEUROCHEMISTRY
Application Form for Membership

" I wish to be considered for Membership of ESN"
· Ordinary Member (Annual due: 25 Euro)*
· Sustaining Member (Please, contact the Treasurer for the fee)
· I apply for reduced membership fee (Please provide a reason to the Council)

Name (Last, First, Middle)_________________________________________________

Current Position______________________Degree(s):________________________

Institution_____________________________________________________________

Mailing address_______________________________________________________

Country____________________ Telephone:__________________Fax: _________

E-mail ____________________

Applicants must enclose a short CV and a list of recent publications OR should be supported by the signature of one ESN Member.

Supporting Member (block capitals): _____________________

Signature: ___________________________________________

I share the aims of the European Society for Neurochemistry (see ESN Constitution at ESN WebPages)

Candidate Signature _______________________________ Date: __________

Please, send the completed application form to:
Dr. Dusan Dobrota,
Department of Biochemistry,
Comenius University,
Jessenius Faculty of Medicine
Malà Hora 4
03601 Martin, Slovak Republic
dobrota@jfmed.uniba.sk

*Applicants will pay the membership fee, following acceptance, to:
"The European Society for Neurochemistry", Account No: 65120763, The Cooperative Bank, Stockport Business Direct, PO Box 250, Skelmersdale,WN8 6WT, U.K.,
Bank Sort Code: 08 92 99, Swift Code: CPBKGB22