Membership Application

This form can be used to apply for ISSWSH membership. Your membership application will be reviewed by the membership committee and approved by the Board of Directors. If approved, you will become a member and your payment will be processed.

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 info@isswsh.org.

Personal details

For example, Dr., Prof.

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 info@isswsh.org or someone from our office will be reaching out to you to provide this.
Max. 250 characters - 250 characters left

Home address

Work address

Billing address

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