ESPE Working Group on Obesity Membership Application

Please complete the below application form to become an ESPE Working Group on Obesity member:

ESPE Working Group on Obesity Membership Application

Candidate – Personal details

Personal title

First name

Surname

Nationality

Institution

What is your current work position?

Personal email address

I am an ESPE member

Yes

If not , you can become a member here

Aiming for diversity and inclusion in the ESPE Working Group on Obesity we would like to have a few more details on your expert level in paediatrics or (paediatric) endocrinology/diabetology.

Are you

A PhD student

A trainee

Not applicable

Do you have less than or up to 5 years experience following obtaining the last degree (specialisation/fellowship/PhD)?

Yes

Consent and declarations

Consent for storing submitted

I confirm that all the information given on this form is my own and is correct

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