Membership Application

This form can be used to apply for membership to the Scientific Network on Female Sexual Health and Cancer. Your membership application will be reviewed and you will be notified by email when it has been approved.

All data submitted on this form will be processed on a Secure Server (SSL), which is owned and maintained by the company managing the Scientific Network on Female Sexual Health and Cancer Office 'Status Plus B.V.' in The Netherlands. For more information please contact us by phone +1 (952) 683 9044 or e-mail

Personal details

For example, Dr., Prof.

For example, Jr., Sr., II etc.
For example, MD, PhD etc.
Professional Clinicians, Practitioners or Researchers and Student/Trainees are required to provide a CV/Resume when applying for Scientific Network membership. If you have not provided an online link to your CV/Resume, please email it to

Social accounts

Max. 250 characters - 250 characters left

Home address

Work address

Billing address