E H A / Membership / Apply for EHA membership

Apply for EHA membership

Here you can apply for EHA membership on-line. The current annual membership fee is â‚¬ 150 per calendar year (January to December). Hematologists within 15 years of graduation or with less than 10 years of post-doc experience, qualify for the junior membership fee â‚¬ 95 per calendar year (January to December). The mentioned fees are excluding â‚¬ 5,- handling costs.

I would like to apply for EHA membership for: 2010 2011

EHA membership number:

Have you been a member of the EHA before?: No Yes

Membership type: Full membership Junior membership [requires a copy of your CV please send your CV to: membership@ehaweb.org]

Last name:

First Name, Middle Initials:

Gender: Male Female

Date of birth (dd/mm/yyyy)

Title:

Title 2 (Behind your last name):

With the provided information, you will be addressed as follows:

Institution*
Department
Institution Address
Postal Code / Zip
City
Country (select one from the list)
Telephone
Fax
E-mail
How did you learn about EHA?
What is your main reason for becoming an EHA member?
Will your membership be sponsored?
Yes
Name sponsor

Affiliation*
University Hospital
Private Hospital
Medical school
Industry
Other affiliation:

Training
MD
PhD
Internist
Hematologist
Oncologist
Other training:

Primary fields of interest (please mark the appropriate box, max 3]
Hematological malignancies
Hematopoiesis
Molecular hematology
Granulocytes/monocytes
Immunohematology
Lymphocytes
Red cell disorders
Cytokines
Coagulation- clinical
Coagulation- basic science
Stem cell transplantation
Gene therapy
Pediatric hemat-oncology
Platelets/megakaryocytes
Other primary field:

EHA-ASH Translational Research Training in Hematology (TRTH) Award

EHA-ESH 16th Hematology Tutorial FOCUS ON ACUTE MALIGNANCIES

EHA - JosÃ© Carreras Award

EHA Jean Bernard Lifetime Achievement Award

Apply for EHA membership