ESPT MEMBERSHIP – Student

Price:

30€

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Institution:* Institution is Required

Department:* Department is Required

Date of birth: Date of birth is not valid

Qualification:* Qualification is Required

MD PharmD PhD MSc BSc Other

I use pharmacogenomics (PGx) today: I use pharmacogenomics (PGx) today is not valid

Yes No

I am active in: I am active in is not valid

PGx Diagnostics PGx Research

Other: Other is not valid

Please describe your research/field of PGx diagnostics: Please describe your research/field of PGx diagnostics is not valid

Describe your job:* Describe your job is Required

Clinician Academician Pharmacist Lab Manager Researcher Post-Doc PhD student Undergraduate student Other

Describe your workplace:* Describe your workplace is Required

University Laboratory Research centre Non-profit hospital or clinic (e.g. academic, governmental) For-profit hospital or clinic Corporate/Business Regulatory affairs Other None

My interest in PGx is related to:* My interest in PGx is related to is Required

Cardiology Psychiatry Oncology Transplantation Other

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Coupon Code:

Invalid Coupon Coupon applied successfully

This site stores users' provided information. I consent to the terms set forth in the Privacy Policy.