Online Application: The International Society of Gynecological Pathologists

Applicant's Information
Name:
E-mail:
Mailing address:


Telephone:
Birthdate:	/ /
Citizen of:
Medical Education
Current position or title:
Medical education:
Degree(s)/M YYYY:	/
Postgraduate Education
Internship:
Specialty training:
Fellowships:
Specialty certification:
Other:
Attach Curriculum Vitae File (Preferably Microsoft Word Format)
Attach CV document:
Attach optional correspondence:
Optional Message/Comments
Message/Comments:
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	Submitting this form with file attachments may take longer than usual depending on the size of the file(s) you have attached. Please be patient and press the submit button only once.

For those applying online using the form above, the following items must be submitted prior to its evaluation by the Membership Committee:

1. An updated copy of your curriculum vitae, including biographical data, medical education, pathology education, specialty certification, academic and hospital positions (state current position first), membership in scientific organizations, and bibliography. This may be attached to the electronic document above using the "attach CV document" option.

2. A description of any special activities in gynecological pathology other than publications. This may be added to the comments section of the above application or attached as a separate document under "optional correspondence."

3. A letter of recommendation, preferably from a member of the Society. You may have the Society member mail it directly to the address below or have them send it electronically using the "Contact the Society" option on the home page of this web site.

4. Be sure to mention in the comments section above if you wish to apply as a practitioner in a developing country. This entitles you to a reduced overall membership cost that includes online-only access to the Society Journal. To view the developing country list, click here.

If you wish to submit your application by mail, you may print the above form using the browser or download the standard application in Adobe acrobat (.pdf) format (20kb). However, the following items must be submitted with the above application prior to its evaluation by the Membership Committee:

2. A description of any special activities in gynecological pathology other than publications.

3. A letter of recommendation, preferably from a member of the Society.

Please note than upon acceptance, the Treasurer will send a bill for dues, which includes a subscription to the Journal at a reduced rate.

Please return a signed and dated copy of the above application form and all supplemental materials to:

Kathleen R. Cho, M.D.

Secretary, International Society of Gynecological Pathologists

University of Michigan Medical School

Department of Pathology

109 Zina Pitcher

1506 Biomedical Science Research Bldg

Ann Arbor, Michigan 48109-2200

USA

Note: New members are approved at the biennial executive committee meeting. Therefore, depending on the time of submission, it may be up to 6 months before a membership application receives final approval. We thank you for your patience.