Online Application for Affiliate BDIAP Membership

Name:
Professional address:
Phone:
-
E-mail:
Qualifications (including place and date):
Nationality:
Year of birth:
Present post:
Previous appointments:
Do you have a Masters Degree? If so give the year it was attained
Are you in training for a Masters Degree? If so give the expected year of completion
Have you passed the IBMS Diploma of Expert Practice in Histological Dissection? If so give the date attained
I agree to abide by the Constitution and Bye Laws:
Nominator:
Seconder: