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Executive Office
Department of Surgery
2/F Professorial Block
Queen Mary Hospital
Pokfulam, Hong Kong
Tel: (852)2818 0232 /
(852)2855 4235
Fax: (852)2818 1186
E-mail: isds@hku.hk

Founded as the Collegium Internationale Chirugiae Digestivae

Download Membership Application Form

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(Word format)

Membership Application

General informations

Name:

Address:

City:

State:

Zip Code:

Country:

E-mail:

Phone (Home):

Phone (Work):

Fax:

Date of birth:
(If you are less than 40 years of age and wish to claim the reduced dues available to young surgeons, send a copy of your birth certificate, passport or other similar documentation)
(dd/mm/yy)
Nationality:

Medical Schools

Medical School 1:

Date attended 1:

Degree(s), Year Awarded 1:

Medical School 2:

Date attended 2:

Degree(s), Year Awarded 2:

Medical School 3:

Date attended 3:

Degree(s), Year Awarded 3:

Postgraduate training in surgery

Training 1:

Year 1:

Training 2:

Year 2:

Training 3:

Year 3:

Appointments

Previous appointments 1:

Previous appointments 2:

Present position:

Memberships

List the national or international surgical or gastroenterological societies of which you are a member.

a. National:

b. International:

Curriculum Vitae

Please enter a list of your publications and a brief curriculum vitae:

Sponsor

Sponsor (who must be ISDS Members)
The following has kindly agreed to propose me as suitable for membership in the Collegium Internationale Chirurgiae Digestivae (ISDS).

Sponsor's Name:

Sponsor's Address:

Sponsor's E-mail:

Please enter validation code on left.

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