Application form for the WMSM 2027 Scientific Program Committee
Name
*
First Name
Last Name
Email
*
example@example.com
Country
*
Profession/Title
*
How long have you been working in sexual medicine for?
*
I'm still in training
1-5 years
6-10 years
More than 10 years
Other
Primary area of expertise in sexual medicine
*
Allied health / rehabilitation
Andrology / male infertility
Basic science / translational research
Endocrinology
Female sexual dysfunction
Male sexual dysfunction
Oncology related sexual medicine
Pelvic health / gynaecology
Psychiatry / psychology / sexology
Public health / epidemiology (sexual health)
Other
Which society/societies are you a member of?
*
ISSM
MESSM
APSSM
ESSM
ISSWSH
SASSM
SLAMS
SMSNA
Gender identity
Male
Female
Non-binary
Prefer not to say
Other
Have you previously served on a Scientific Program Committee for ISSM or one of its affiliated societies (e.g., WMSM, ESSM, SMSNA, APSSM, SLAMS, MESSM, SASSM)?
*
Yes
No
If yes, for which meeting and in which role?
Please select which sub-committees you would be interested in joining?
*
Basic and translational research
Female sexual (dys)function
Male sexual (dys)function
Novel and innovative therapies
Oncosexology
Psychosexual aspects
Reconstructive surgery
Sexual orientation and identity
Sociosexual aspects
Please provide a short statement on any previous experience you have with regional or international event program committees, ISSM or related journals or any other volunteer experience that may benefit this role.
*
Please provide a short statement to support your interest in joining the WMSM 2027 Scientific Program Committee.
*
Please submit your CV
*
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