TREAT-NMD Alliance - Membership Form

Apply for TREAT-NMD membership


Membership of TREAT-NMD is open to individuals, organizations, academic institutions, patient/disease organisations, and industry.

If you have any questions please contact us at info@treat-nmd.eu

  • Please select most appropriate membership option and complete the sections indicated.

  • Section 1 - Applicant



    This section is mandatory for all applicants

  • Please enter your name here.

  • Please enter a valid email address - submission confirmation will be sent to this address

  • Please complete your affiliation or organization name here.

  •  

    Please add the address here. If you're applying for an individual membership and are not affiliated to an organization please enter your home address. We need it to post out your membership certificate. This will not be passed on to anyone else and only your country location will be shown on the website.

  • Please add your organization's web site address here.

  • Please select one option.

  • If you selected 'Individual - other' please provide additional information.

  • Section 2 - Individual Membership



  • Section 3 - Organizational Membership



  • Please select one option.

  • Your information may or may not be publically displayed on the TREAT-NMD website depending on your choice here.

  • We will never pass your details on to anyone else.

  • You need to agree to this section to enable your membership to proceed any further.

  • Data Protection Statement:

    The data you submit may or may not be included on the TREAT-NMD website depending on the choice you made on this form.

    Your data will however be included in the membership registry which will be made available to all members.

    Please note the information submitted here will be held be the TREAT-NMD Coordination office and will not be passed on to any third parties.



 
12 Apr 2017