Membership Application

This form can be used to apply for ISSWSH membership. Your application will be reviewed by the membership committee and Board of Directors. We will notify you of the decision by email. Please keep in mind this process can take a few weeks

All data submitted on this form will be processed on a Secure Server (SSL), which is owned and maintained by the company managing the ISSWSH Executive Office 'Status Plus B.V.' in The Netherlands. For more information please contact us by phone +1 (952) 683 9025 or e-mail

Personal details

For example, Dr., Prof.

For example, Jr., Sr., II etc.
For example, MD, PhD etc.
A CV/Resume is required when applying for ISSWSH membership. If you have not provided an online link to your CV/Resume, please email it to or someone from our office will be reaching out to you to provide this.

Social accounts

Professionally, what do you spend more than half your time doing?
Max. 250 characters - 250 characters left

Home address

Work address

Billing address


ISSWSH Executive Office
 +1 (952) 683 9025
 +1 (952) 314 8212