Your personal data
:
Family
Name
:
First Name:
Are
You :
:
Male :
Female
Nationality
:
(passport)
Year of Birth:
Institution
:
City:
Position
held:
Your
Address :
City
:
Postcode:
Country:
Telephone
:
FAX :
E-mail adress:
For
what week(s) would you like to apply ?
Week1
:
15 - 20 Oct:
Medical Imaging-1
Week2
: 22 - 27 Oct:
Medical Imaging-2
Week3
: 29 Oct. - 3 Nov: Medical
Computing
Week4
: 5 - 10
Nov:
Physics of Modern Radiotherapy
Week5
: 12 - 17 Nov
:
Brachytherapy
Week6
: 19 - 24 Nov :
RADIOPROTECTION
The following information is compulsory to apply :
Give "Year One", i-e the year you obtained the
diploma which gave you direct access to doctoral studies (MSc or
equiv.):
I have no Phd and less than 4 years since
"year One"(full
time equivalent)
I have a Doctoral
degree and between 4 to 10 years since "year One"(full
time equivalent)
I have a Doctoral
degree and more than 10 years since "year One"(full
time equivalent)
An
extended summary of your CV
(compulsory and at least 15 lines):
Note: Application without complete information (incl."Year One" and Summary of
CV) will not be considered.
Please
reserve a place for me at the 2009 session
of the European School of Medical Physics
After
submission of the form, you normally receive a warning saying that your
e-mail address will
be revealed to the receiver... click OK, and then "document done" will
appear.
In
that case it is OK !
If
you have problem sending the form automatically, Click here to
copy the Form and paste it in the following e-mail
: ESMP