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Insert data Language *    English  French Title * Select title Dr. Mr. Mrs. Ms. Prof. Prof. Dr. Rev. First Name * Surname – Family name * Profession * Select profession Administration Auxiliary Nurse Chemistry Clergy/Chaplain Complementary Therapist Dentist Dietician Economist Editor Entrepreneur Ethician Health Economist Hospital Pharmacist Journalist Lay-person Local Association Neurobiologist Nurse Occupational Therapist Other non specified Para-medical Pharmacist Physician Physiotherapist Politician Psychologist Researcher Sexologue Social Scientist Social Worker Sociologist Statistician Student Teacher Volunteer Volunteer co-ordinator Address:    work  home Institution Department Address * Town * Zip * Country * Choose your country AFGHANISTAN ALBANIA ALGERIA AMER.SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA & BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA & HERZEGOVI BOTSWANA BR. VIRGIN ISL. BRAZIL BRUNEI BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISL. CENTR. AFRICAN REP CHAD CHILE CHINA CHINA-HONG KONG CHRISTMAS ISL. COCOS (KEELING) IS COLOMBIA COMOROS CONGO COOK ISL. COSTA RICA COTE D'IVOIRE CROATIA-HRVATSKA CUBA CYPRUS CZECH REP. DENMARK DJIBOUTI DOMINICA DOMINICAN REP. E. TIMOR ECUADOR EGYPT EL SALVADOR EQU.GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISL. FAROE ISL. FIJI ISL. FINLAND FR. GUIANA FR. POLYNESIA FRANCE GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HONDURAS HUNGARY ICELAND INDIA INDONESIA IRAN IRAQ IRELAND islas malvinas ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, NORTH KOREA, SOUTH KUWAIT KYRGYZSTAN LAOS LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACEDONIA MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISL. MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA MOLDOVA MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETH. ANTILLES NETHERLANDS NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISL. NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA N.GUINEA PARAGUAY PERU PHILIPPINES POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIA RWANDA S. AFRICA SAN MARINO SAO TOME & PRINCIP SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISL. SOMALIA SPAIN SRI LANKA ST. HELENA ST. KITTS & NEVIS ST. LUCIA ST. PIERRE & MIQUE ST. VINCENT&GRENAD SUDAN SURINAME SWAZILAND SWEDEN SWITZERLAND SYRIA TAIWAN TAJIKISTAN TANZANIA THAILAND TOGO TOKELAU TONGA TRINIDAD & TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS & CAICOS ISL TUVALU U. ARAB EMIRATES U. S. VIRGIN ISL. U. STATES UGANDA UKRAINE UNITED KINGDOM URUGUAY UZBEKISTAN VANUATU VATICAN CITY VENEZUELA VIETNAM WALLIS & FUTUNA IS YEMEN YUGOSLAVIA ZAMBIA ZIMBABWE Tel.Code Telephone Fax Mobile EMail 1 * EMail 2 EMail 3 I wish to adhere as Individual member (paying a fee of 60.0 Euro) Member of an Association (collective member) Registered user (EAPC mailing list) I am a member of Select membres collectives AHPCP ANIP APCP APCSW APMGB BK CACS CAHF CrSPM CSPM DGP DSPaM DVHO FBSP FCP FPCF FWSP HAPCPC HHPA HSPSCCNCP HtH IANPC IAPC Ice IAPC Irl IAPC Isr IOELC IPMS LPMA NFPM NPA NPTN NRPV OPG PALL PAPC PASYKAF PCRS SCBCP SECPAL SFAP SFPM SICP SPLY SRPT SSMSP test and wish to get access Position Choose your position President Vice President__Vice Président Secretary__Secrétaire Treasurer__Trésorier BD Member__Membre CA Other Disabled Sponsor Position Choose your sponsor position Product Manager Senior Vice President Administrateur utente Amministratore Delegato Chief Scientific marketing Corporate Medical Director Director Senior Product Manager Marketing Manager Responsabile Marketing EAPC Member data Year   EAPC Number EAPC newsletter yes   no Choose your password * Confirm your password * P.S.: Fileds with * are obbligatory