Application for JCTLM Membership

Application for

JCTLM Membership

Please complete the form below if you wish to apply for membership

Full information on the membership categories is available on the JCTLM website .

Information on the Organization

Official name of the Organization *

Acronym of the Organization *

Address of the Organization *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Website address *

Nature of the Organization *

Contact information

All mail and email correspondences from JCTLM will be sent to the following contact person(s)

Main Contact :

Title *

Prof. Dr Mrs/Ms Mr

First Name *

Last Name *

Position in the Organization *

Tel *

Email *

Other contacts:

Please list below the other contacts, if any (specifying title, first name, last name, position, telephone number and email address)

Description of your Organization

Please describe the aims and subject fields of your Organization *

Please provide a summary of the activities being undertaken by your organization to reduce the between method variability in laboratory medicine measurements *

Please describe any previous interaction/support of the JCTLM *

Please list the organization(s) you are member of

Please list your affiliated members

Please select the membership being sought *

Please upload any relevant document