Young ESGAR Application Form
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Your Name
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First Name
Last Name
Date of Birth
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Day
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Month
Year
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Institution (Hospital, City, Country)
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I am a:
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Junior Resident (1st - 3rd year)
Radiologist
Senior Resident (4th+ year)
Do you have any suggestions, i.e. new initiatives that YE should launch or goals we need to achieve etc?
Please upload a copy of your CV and picture of yourself for our membership list:
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Thank you for filling out this form and welcome to Young ESGAR!
In case of questions, you can contact us via youngesgar@esgar.org
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