Membership Application Form

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I hereby apply for membership of the International Academy of Aviation and Space Medicine as:

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I subscribe fully to the objectives of the Academy. I am exercising clearly established functions and activities in the field of Aviation, Space Medicine, or related sciences as:

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In further support of this application, the following enclosures are submitted (in English or French):

1. Evidence of qualification in medicine or in an allied science; (photocopies of Degrees and Diplomas)

2. A Curriculum Vitae including:
a) A description of previous and present professional activities - highlight activities in aviation or space medicine;
b) A list of personal publications if any - list separately, or highlight, any aviation or space medicine publications;
c) A statement of aviation activities, including personal flight experience;
d) A statement of membership and status in professional and aeronautical societies.

3. A recent photograph;

4. Written recommendations from two members of the Academy (one of whom being preferably a Selector) to act as sponsors (one sponsor
must have known the candidate for at least three years).

Please contact the Secretary General if you have difficulty with the requirement for Letters of Recommendation.

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I agree to my application being retained by the Academy in accordance with its data protection policy.

I certify that information contained in any document pertaining to my application for membership is accurate, and that any copy of a document which is submitted is a true representation of the original.

International Academy of Aviation and Space Medicine