EURACT - European Academy of Teachers in General Practice

It should be easy to apply for membership of this organisation. You need to discuss it with your National Council member, listed on the website with contact details.

You apply using the form below. The application will be supported by your Council member at the next Council meeting and should then be approved. You are expected to pay for membership in advance, 50 Euros each year.

Please be aware that you are not a member unless this process has been completed and cannot participate in any formal proceedings, such as standing for, or election to, Council membership. You will also forfeit your membership if you do not pay tour subscription in the appropriate calendar year.

May we wish you success with your application and please make sure you use and enjoy your membership.

Personal Information Form

Please fill out this form with electronically or in capital letters.

Membership type:

Member\nAssociate member\nOrganisation in collaboration\nOther\n

Surname (+title):
First name:
Birth date:
Contact person of "organisation in collaboration":
Private address:
Country:	Albania\nAndorra\nAustria\nBelgium\nBelorussia\nBosnia and Herzegovina\nBulgaria\nCroatia\nCyprus\nCzech Republic\nDenmark\nEstonia\nFinland\nFrance\nGeorgia\nGermany\nGibraltar\nGreece\nHungary\nIceland\nItaly\nLatvia\nLiechtenstein\nLithuania\nLuxembourg\nMacedonia\nMalta\nMoldova\nMonaco\nMontenegro\nNetherlands\nNorway\nPoland\nPortugal\nRomania\nRussia\nSan Marino\nSlovakia\nSlovenia\nSpain\nSweden\nSwitzerland\nTurkey\nUkraine\nUnited Kingdom\nVatican City State\n
Phone:
Fax:
E-mail:
Are you member of teaching organisation?	yes no

Structure of this teaching organisation:	University\nProfessional group\nTrade union group\nGovernmental body\nOther\n
Your function in this organisation:
Area covered by this organisation (more than 1 possible):	Basic Medical Education Vocational Training Continuing Medical Education Other
Name of teaching organisation:
Address:
Country:	Albania\nAndorra\nAustria\nBelgium\nBelorussia\nBosnia and Herzegovina\nBulgaria\nCroatia\nCyprus\nCzech Republic\nDenmark\nEstonia\nFinland\nFrance\nGeorgia\nGermany\nGibraltar\nGreece\nHungary\nIceland\nItaly\nLatvia\nLiechtenstein\nLithuania\nLuxembourg\nMacedonia\nMalta\nMoldova\nMonaco\nMontenegro\nNetherlands\nNorway\nPoland\nPortugal\nRomania\nRussia\nSan Marino\nSlovakia\nSlovenia\nSpain\nSweden\nSwitzerland\nTurkey\nUkraine\nUnited Kingdom\nVatican City State\n
Phone:
Fax:
E-mail:
Preferred mailing address:	Home Work

Describe in 8 lines your activity or activity of organisation in collaboration: